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Minimally Invasive Surgery (laparoscopic and robotic)

Minimally invasive surgery (MIS) (key hole surgery) has become the standard treatment for many straightforward surgical procedures in the abdomen such as cholecystectomies (gallbladder removal), appendicectomies and colectomies. In general, it has also been shown to be superior to the conventional open technique in the field of HPB surgery resulting in less postoperative pain, decreased blood loss, less wound complications and shorter hospital stay. However, widespread adoption of MIS in the field for hepatopancreatobiliary (HPB) surgery remains limited mainly due to the highly complex nature of many of these surgical procedures. Hence, MIS HPB surgery is presently only routinely performed by expert surgeons in selected high volume specialized institutions.

Department experience and annual caseload

The department has a vast experience in performing MIS for complex liver, pancreatic and biliary procedures and is recognized internationally for its expertise. Presently, it is the highest volume center in the field for MIS in Singapore and one of the highest in the region.  Since starting its MIS program for liver and pancreatic resections in 2006, it has performed over 600 laparoscopic/robotic procedures for major HPB surgeries as of 2017 including over 400 liver resections and 100 pancreatic resections. It is also the pioneer of robotic HPB surgery in the region starting its formal program in 2013 and has performed over 70 major robotic HPB procedures to date.  Robotic surgery is used selectively to complement conventional laparoscopy allowing more complex procedures to be completed successfully via MIS.

Its surgical results (conversion rate, morbidity and mortality) for MIS are on par with the very best centers worldwide and has been published in numerous prestigious international journals. At present, its 30-day mortality rate for major HPB procedures performed via MIS is less than 0.5 %.

Presently, the department performs over 100 major HPB procedures per annum via MIS for a variety of complex procedures including pancreatoduodenectomies (Whpples procedure) and major liver resections. It also performs about 500 laparoscopic cholecystectomies per annum. In addition, the department's surgeons also perform MIS for other general abdominal surgical and oncological procedures such as splenectomies, bowel resections and hernia repair.