19 May 2011
By: NG WAN CHING
KK Women’s and Children’s Hospital’s first single port surgery (surgery performed entirely through the navel) was done to remove a woman’s womb on Sept 1, 2009.
Said Dr Anthony Siow, director of the Minimally Invasive Surgery Centre at KK Women’s and Children’s Hospital: “The outcome was a success. The patient didn’t even need any painkillers and was home two days after surgery.” He performed the surgery with Dr Jasmine Mohd.
Eight days later, on Sept 9, four KKH surgeons carried out the world’s first emergency operation for a rare ectopic pregnancy entirely through the navel, using several specialised instruments.
The four surgeons were Professor Tan Kok Hian and Associate Professor Bernard Chern – the chairman and deputy chairman respectively of the division of obstetrics and gynaecology – and Dr Jasmine and Dr Steven Teo, both from the department of obstetrics and gynaecology,
Compared with conventional laparoscopy (keyhole surgery) in which the surgeon makes three or four small cuts on the abdomen to allow medical instruments to be inserted, single port surgery is carried out with only one cut through the navel.
It uses several specialised instruments inserted through a special port which is attached to the cut in the navel to enable surgeons to carry out the same procedures.
Dr Siow said: “As KKH started single port operations, I focused on refining the steps for single port hysterectomy as well as optimising the use of advanced instruments to make single port procedures easier.”
Together with Dr Quek Swee Chong, head of the pre-invasive and screening unit at KKH, he performed Singapore’s first single port myomectomy (fibroid removal) on Sept 24 last year.
Since then, KKH doctors have performed 45 hysterectomies, 28 myomectomies and 20 adnexectomies (tube and ovary removal).
Dr Siow says interest is growing and he has many requests to conduct workshops, including in the region.
“The most recent was in Jakarta last week where we successfully performed a single port hysterectomy,” he said.
National University Hospital (NUH) has done fewer than 10 single port operations since its obstetrics and gynaecology department first removed a benign ovarian tumour through a patient’s belly button in July 2009.
It now provides single port surgery for hysterectomies, fallopian tube removals, ovary removals and fibroid removals.
Dr Fong Yoke Fai, senior consultant at NUH’s department of obstetrics and gynaecology, said: “We hope to be able to perform robotic single port surgery soon.”
At Singapore General Hospital (SGH), single port surgery has been available since 1989 for ligation procedures.
It was only after the new single incision laparoscopic port was introduced that SGH started offering single port surgery for other gynaecological conditions about six months ago.
Dr Siow said of the latest port which was introduced early this year: “The channels where the instruments go into are more flexible and angled so there is less crowding of instruments in the abdomen.”
Said Dr Hemashree Rajesh, consultant at SGH’s division for reproductive medicine: “We now offer it for removal of ectopic pregnancies, cysts and ovaries. We have done 10 such operations so far.”
SGH will soon offer single port surgery for hysterectomies.
Single port surgery is also available for other types of operations for both female and male patients.
Doctors here have done operations using this technique since the end of April 2009 on patients with gall stones, stomach tumours, inflamed appendices and hernias.
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