David Zimmerman

We suggest imaging according to this algorithm; but love to have the discussion! We firmly believe imaging is underutilized in fistula surgery! pubmed.ncbi.nlm.nih.gov/33180233/

ESCP guidelines emphasize loose setons as a safe, sphincter-preserving option for complex anal fistula. But does technique matter for patients. In our randomized controlled trial, we compared three different seton knot techniques in high transsphincteric anal fistulas. Key finding: QoL significantly improved over time in all groups, with no difference between knot types. rdcu.be/e1o7f

Start of a new marathon with more than 40 participants. Excellent review of the exam process ✌🏼Waiting to host all candidates in İstanbul ✌🏼

Feeling so lucky with my course directors! Big thanks to David and Nunoo for letting me practice on the Medtronic HUGO robot—also huge shout-out to @ISUCRS for making it happen!

📊 Top 30 Countries by Health Care Index (2025 Mid-Year) 1. 🇹🇼 Taiwan — 87.0 2. 🇰🇷 South Korea — 82.8 3. 🇳🇱 Netherlands — 80.6 4. 🇯🇵 Japan — 80.2 5. 🇦🇹 Austria — 78.5 6. 🇩🇰 Denmark — 78.3 7. 🇪🇨 Ecuador — 78.0 8. 🇫🇮 Finland — 77.4 9. 🇪🇸 Spain — 77.3 10. 🇹🇭 Thailand — 77.3 11. 🇫🇷 France — 77.2 12. 🇳🇴 Norway — 75.8 13. 🇧🇪 Belgium — 75.8 14. 🇨🇿 Czech Republic — 75.5 15. 🇱🇺 Luxembourg — 75.1 16. 🇪🇪 Estonia — 74.8 17. 🇱🇹 Lithuania — 74.7 18. 🇶🇦 Qatar — 73.5 19. 🇮🇱 Israel — 73.4 20. 🇦🇺 Australia — 73.1 21. 🇲🇽 Mexico — 72.7 22. 🇬🇧 United Kingdom — 72.5 23. 🇵🇹 Portugal — 72.0 24. 🇸🇬 Singapore — 71.8 25. 🇩🇪 Germany — 71.7 26. 🇱🇰 Sri Lanka — 71.4 27. 🇹🇷 Turkey — 71.3 28. 🇨🇭 Switzerland — 70.8 29. 🇲🇾 Malaysia — 70.7 30. 🇦🇪 United Arab Emirates — 70.7 📖 Source: Numbeo 2025

@ciirarref So can you explain in what way she, or the situation, will improve after airing this in social media? In what way will this help you or her? I think it is embarrassing and unprofessional for you and your service to out her in this way.

This med student: 1. Doesn't show up on time (WAS ONE HOUR LATE TO ROUNDS, TWICE) 2. Doesn't see 2 patients when given ONE HOUR AND THIRTY MINUTES 3. Doesn't present coherently 4. Doesn't listen to basic instructions 5. Doesn't work on the list 6. Doesn't communicate when she will be gone, and just LEAVES the hospital mid day when given a task 7. Asks US to notify HER when a case is starting 8. Interrupts attendings and residents when they're talking. Frequently. 9. Literally asked her to scrub a case today and she said okay and didn't scrub it without telling anyone. 10. Is actually unteachable. 11. Started randomly eating a granola bar mid instruction for a task?????? hello???? I'm straight up wondering if I can kick her off the service. You want to be an anesthesiologist and can't even be bothered to show up on time or communicate????? At least TRY????

We are starting the planning of our new OR dpt. What innovations or design features do we have to look into to optimise our minimally invasive surgery suites? @escp_tweets @ASCRStweets @DSCRS_NL #colorectalsurgery @SWexner

@TechColoproctol have you fixed the flaw yet so that Letters to the editor can be published free of charge?

@drkeithsiau @TedEdson1 Recto-anal inhibition reflex!

@TedEdson1 What’s RAIR?

CT scan of a 20M with abdominal pain and vomiting. What’s the diagnosis?

@dickandtinasson @OGdukeneurosurg That is not general surgery ; it is a highly specialized procedure for colorectal surgeons!

@OGdukeneurosurg General surgery, Lower Anterior Resections

Which medical specialty has the dirtiest job ?

@deanlute @escp_tweets @DCRjournal Hi Dean! The size of the internal opening does not influence the technique or outcome of Flap repair; so indeed I would suggest a core-out and bulky flap. I see no use for stoma’s; a benefit has never been shown.

What is your approach to a high anal fistula with a large internal opening? This may be a group that needs a stoma and bulky flap. Not sure. Interested in opinions/experience. #colorectalsurgery @escp_tweets @DCRjournal

Authors: Harald Rosen, Álvaro García-Granero, Eloy Espín, @zimnl @ign76 @klaartjekok @manuelefurnari @ssiakavellas @popovulli @maxschinaglueg 💙 Gutflix is your destination for GI education: gutflix.eu

🎉 Big cheers to all who passed the @EBSQcolo Exam in Paris (Sept 12–13, 2025)! 🥂 Welcome to the club of EBSQ-certified Colorectal Surgeons 🚀 Came for the exams, left as champions — a career milestone unlocked! 🚀 uemssurg.org/surgicalspecia…

📝🤔Are you considering taking the EBSQ exam? 👉Demonstrate your knowledge of #Coloproctology 👉Reach the highest standards both clinical & #research 👉Internationally recognised 👉Become an opinion leader & participate further in the activities of the Society! #SliceOfTheDay

"A man cutting meat 🐄 ≠ surgeon 🔪". An interesting talk by @ZimNl about the importance of examination @UEMSEurope- Division of Coloproctology. Dieter Hahnloser Fatma Ayca Gultekin, MD, Int-FASCRS, FEBS-Coloproctology #ESCP25 #SliceOfTheDay @escp_tweets

@drkeithsiau 13 fistula related deaths! 😳

Causes of death in London in 1632 🪦💀 - what stands out here?

@Dhananjayasha19 Incredible!!! linkedin.com/pulse/open-acc…

Nature publishes an article titled “How can I publish open access when I can’t afford the fees?” Also Nature: Pay to read it 🤯 You simply cannot parody this industry 🤦‍♂️ #OpenAccess #AcademicIrony #PaywallOnPaywalls #GlobalSouthResearch #YouMustBeKidding

How well does Goodsall’s Rule hold up to modern imaging? We revisited this surgical classic with MRI in 305 fistula cases. The result: ~49% accuracy overall. Anterior fistulas predict better; posterior less so. MRI is essential. turkishjcrd.com/pdf/b0c0ce94-e… Excellent retrospective analysis from our Pelvic Radiology team. Thanks to our rising star @digdemkuruoz for the huge effort. @TKRCD_ @ZimNl @SezaiLeventoglu @IEGecim @Ankaratip1945 @nlavellaneda @turkdiscolrect

@enderguder @SezaiLeventoglu @nlavellaneda @EmreBalikMD @cihangirakyol @TKRCD_ @tkrcd2025 Congratulations!

Absolutely, the first drinks are on me… @nlavellaneda @ZimNl