What is laparoscopic surgery?
Laparoscopy uses long thin instruments and tiny cameras to perform surgery through small incisions.
What is robotic surgery?
Robotic surgery has similar components to laparoscopic surgery, but surgery is performed with the help of a surgical robot. This allows the surgeon to have a magnified 3-dimensional view of the surgical site, providing better views for the surgeon and allowing the surgeon to operate with improved precision and dexterity.
There has been some evidence in recent studies that robotic surgery may be better than laparoscopic surgery for rectal cancer. The benefits include:
- Lower conversion rate to open surgery
- Possibility of better margins in cancer resection
What are the benefits of laparoscopic and robotic colorectal surgery? Are they really better than open surgery?
Minimally invasive surgery has been proven in many studies to be better than open surgery. Its benefits include:
- Shorter hospital stay
- Better cosmesis from smaller wounds
- Less pain
- Faster recovery
In the longer term, minimally invasive surgery has also been found to be associated with:
- Lower incidence of wound site hernias
- Lower incidence of complications related to adhesions such as intestinal obstruction
- Evidence of good long-term cancer survival
What types of colorectal conditions can laparoscopic and robotic surgery be used to treat?
The most common reason for laparoscopic and robotic colorectal surgery is for the removal of colorectal cancer. Although open surgery with large wounds was the standard of care for colorectal cancer treatment for many years, minimally invasive surgery has become standard of care in recent years.
Laparoscopic and robotic approaches can also be used for surgical treatment of the following conditions:
Are there situations when laparoscopic and robotic surgery are not recommended?
Minimally invasive surgery may be challenging in certain patients. These may include patients with:
- Previous abdominal surgeries, when there may be adhesions from previous surgeries
- Unstable clinical condition with bowel perforation or large amounts of bleeding
- Very poor lung or heart function
However, these are not absolute contraindications to minimally invasive surgery. Your surgeon will be able to assess your condition and advise you if it is safe to proceed with laparoscopic or robotic surgery.
For more information, please consult a colorectal surgeon.
Senior Consultant Colorectal Surgeon
MBBS, MMed (Surgery), FAMS, FRCSEd
Dr Tan Wah Siew was senior consultant surgeon at the Department of Colorectal Surgery, Singapore General Hospital (SGH) prior to her move to private practice. She was the first female consultant colorectal surgeon in the history of SGH, and was one of the earliest female surgeons in Singapore to be trained in robotic colorectal surgery.
She graduated from the Faculty of Medicine, National University of Singapore in 2003 and completed her Advanced Surgical Training in General and Colorectal Surgery at SGH in 2011. In 2013, she completed a one year Ministry of Health sponsored Healthcare Manpower Development Plan Fellowship (HMDP) at St. James University Hospital in Leeds, United Kingdom. While there, she trained in minimally invasive and robotic colorectal surgery for colorectal cancer, surgery for inflammatory bowel disease as well as treatment of locally advanced rectal cancers and recurrent pelvic cancers requiring removal of multiple organs and/or pelvic exenterations.