Minimally invasive surgery for colorectal disease

Minimally invasive surgery, often referred to as laparoscopic surgery, is rapidly becoming the gold standard in colorectal surgery for its ability to reduce recovery time and post-operative complications.

“I consider laparoscopic surgery as the treatment of choice for diseases affecting the colon and the rectum,” said Dr Ooi Boon Swee, a senior consultant colorectal surgeon at Mount Elizabeth Hospital in Singapore. He added that many patients nowadays ask for laparoscopic surgery because they are aware of its benefits and advantages.

The reasons for such preference are well founded. “Laparoscopic surgery is superior to open surgery in terms of physical recovery” said Dr Ooi.

The most significant advantage with laparoscopic surgery is the smaller incisions that are made compared to open surgery. Smaller wound means less pain, which in turn reduces the need for pain medication after surgery. As a result, laparoscopic surgery decreases the common side effects associated with these drugs such as nausea, vomiting and drowsiness. It also improves the functional recovery of patient. Patient can get out of bed and walk earlier after surgery. This reduces risks of chest infection and blood clotting, especially for elderly patients who are undergoing major surgery.  

In addition to these benefits, laparoscopic surgery also carries some long-term advantages over open surgery. The incidence of abdominal adhesion, a common complication of any abdominal surgery, where intestines are adherent to each other or to the abdominal wall, is lower in minimally invasive surgery. Adhesion can cause pain and in the worst case scenario, a total obstruction of the intestine requiring a second operation. Similarly, laparoscopic surgery reduces the incidence of incisional hernia, which is common with open surgery because it requires a long wound.

Robotic surgery elevates laparoscopic surgery to the next level

“Robotic surgery is a refinement of laparoscopic surgery because the dissection is more precise, accurate, and tremor-free,” said Dr Ooi. In addition, blood loss is minimal during robotic-assisted surgery although the operation may take longer than laparoscopic surgery.

Dr Ooi stressed that robotic surgery offers a significant advantage in operating on the narrow pelvis.  In the treatment of middle and low rectum cancers, robotic instruments allow surgeons to have a clearer view of the operating field and more freedom of hand movement compared to standard laparoscopy. The pelvic nerves can be identified clearly and preserved, reducing the incidence of post-operative sexual dysfunction, a common side effect of surgery involving the low rectum, especially in male patients. 

Dr Ooi Boon Swee is a Senior Consultant Surgeon at Mount Elizabeth Hospital who specialises in Colorectal, General and Laparoscopic surgery. Previously, he was a Senior Consultant Colorectal Surgeon and Director of Minimally Invasive Surgery at the Department of Colorectal Surgery of the Singapore General Hospital and an Associate Professor at Duke-NUS Graduate Medical School in Singapore.  

B S Ooi Colorectal, General & Laparoscopic Surgery Centre
3 Mount Elizabeth #14-02
Mount Elizabeth Medical Centre
Singapore 228510
Tel: (+65) 6887 3798

Mount Elizabeth Hospital
3 Mount Elizabeth, Singapore 228510

Tel: (+65) 6735 5000
www.mountelizabeth.com.sg