Dr Ooi Boon Swee, colorectal surgeon at Mount Elizabeth Hospital, explains why he considers minimally invasive surgery (also known as laparoscopic surgery) as the treatment of choice for diseases affecting the colon and the rectum.
Laparoscopic surgery, or minimally invasive surgery, offers benefits over open surgery in terms of its ability to reduce recovery time and post-operative complications.
The most significant advantage of laparoscopic surgery is the smaller incisions that are made compared to open surgery. Smaller wounds mean less pain, reducing the need for pain medication after the surgery and decreases the common side effects associated with these medication such as nausea, vomiting and drowsiness.
The smaller incision also improves the physical recovery of the patient. Patients are able to 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 carries some long-term advantages over open surgery. Abdominal adhesions are scar tissue bands that can form between abdominal tissues and organs, causing tissues and organs to stick together. Abdominal adhesion is a common complication of any abdominal surgery, which can cause pain and in the worst case scenario, a total obstruction of the intestine requiring a 2nd operation. With minimally invasive surgery, the risk of abdominal adhesion is lower.
Minimally invasive surgery also reduces the risk of incisional hernia, which is common with open surgery because it requires a long wound.
Robotic surgery is a refinement of laparoscopic surgery because it allows for more technical precision and accuracy. There is also minimal blood loss during robotic surgery although the operation may take longer than laparoscopic surgery.
Robotic surgery offers a significant advantage especially when operating on the narrow pelvis. It allows surgeons to have a clearer view of the operating field and more freedom of hand movement compared to the 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.