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Singapore Medicine - First in South East Asia to Offer Robotic Surgery for Gynaecologic Cancers

Singapore's National University Hospital became the first in Asia to offer the first robotic assisted surgery to gynaecologic cancer patient in August 2008.

Singapore (PRWEB) November 5, 2008 -- Women who need to undergo surgery for gynaecological cancers now have an option to have surgery that is less painful, results in less scarring, allows them to get back on their feet faster while being just as effective in removing cancer - by opting for robotic cancer surgery. With this surgical breakthrough, patients avoid the complications associated with more traditional approaches to surgery for women's cancers.

The Gynaecologic Robot-Assisted Cancer and Endoscopic Surgery at Singapore's National University Hospital surgical programme (GRACES @ NUH) started offering this option to gynaecologic cancer patients in August 2008. The first patient to receive this treatment was a 52-year-old woman with endometrial cancer. She was ready to be discharged after only 48 hours in hospital following a major cancer surgery, and was back on her feet in less than half the time it would take for a patient undergoing traditional surgery for endometrial cancer. She was able to accomplish this feat because she did not have to contend with the painful handicap of a sizeable surgical wound, the side effects of multiple pain medications or weakness from blood loss which remain common problems associated with traditional endometrial cancer surgery.

The GRACES @ NUH surgical team involved in this surgery comprised Dr Jeffrey Low and Prof Ilancheran (both Senior Consultants), Dr Joseph Ng (Consultant), Dr Fong Yoke Fai (Consultant) and Dr Suresh Nair (Visiting Consultant) from the Department of Obstetrics & Gynaecology.

What is Robot-Assisted Cancer Surgery?
Robot-assisted surgical systems involve two integral components - the Surgeon's Console and a Patient Cart. During the surgery, the surgeon sits at the console and controls the actions of the robotic arms that reside in the bedside patient cart where the actual cutting takes place.

Through this surgical system, the surgeon's technical expertise, understanding of disease and knowledge of human anatomy are enhanced by the robot's strength, stability, dexterity, and visualisation. The synergy between man and machine results in higher surgical functionality, which ultimately translates into better surgical outcomes for the patient.

Robot-Assisted Versus Traditional Cancer Surgery
Traditionally, cancer surgery requires that a patient's abdomen be opened as this approach allows the surgeon to use his hands naturally and directly while allowing direct visualisation of the structures. This approach leaves a large surgical wound with common complications of pain, infection and the likelihood of poor wound healing and wound infection. A slower return of bowel function, the need for intravenous fluid support and the need for IV medication to provide adequate post-operative pain relief result in longer hospital stays and slower return to normal daily functioning.

These shortcomings led to the search for a better alternative - minimally invasive surgery. Through minimally invasive surgery, the same surgical objectives can be achieved without the disadvantages of open surgery. Access to the abdominal cavity can be achieved without a large incision, while providing good visualisation with magnification provided by scopes, cameras and optical systems.

Learning to work with key-hole surgery instruments is not an easy task. The surgeon has to learn a whole new set of skills to be able to move and use keyhole surgery instruments within the body cavity.

Robotic surgery represents the latest iteration in a series of improvements and innovations brought to women's cancer surgery. It combines the advantages of traditional open surgery and minimally invasive surgery. Capitalising on the superior visualisation offered by optics in keyhole surgery and pushing this advantage further by providing higher visual definition and stereoscopic third-dimensional vision in the operative field, the surgeon not only sees the operative field more clearly, but also in three dimensions with good perception of depth. Robotic surgery, through its innovative instrumentation, allows the surgeon to operate naturally within the abdominal cavity and directly and intuitively on diseased tissue. This is made possible by the "wristed" instruments which mimic all the degrees of freedom of the human hand.

Dr Jeffrey Low, Head, Division of Gynaecological Oncology explained, "Endometrial cancer is on the rise. Freedom from this disease and the reassurance of knowing that one can be cured of this disease comes from having definitive surgery done in a timely fashion. Robot-assisted cancer surgery provides this definitive treatment while affording patients a smooth recovery with the same ease as patients delivering a baby."

Endometrial cancer is one of the most common cancers among American women. About 40,000 American women are diagnosed with endometrial cancer each year, making it the 4th most common found in women.

Women suffering from endometrial cancer and early stages of cervical cancer should consult their doctors for an assessment to ascertain their suitability for robot-assisted surgery.

About The National University Hospital
The National University Hospital (NUH) is a specialist hospital that provides advanced, leading-edge medical care and services, and is a major referral centre that delivers tertiary care for a wide range of medical specialties. In 2004, the NUH became the first Singapore hospital to receive Joint Commission International (JCI) Accreditation, an international stamp for excellent clinical practices in patient care and safety. It was also the first hospital in Singapore to receive a triple ISO certification concurrently for Quality, Environmental, and Occupational Health & Safety Management Systems in 2002. (

About the SingaporeMedicine Initiative
Launched in 2003, SingaporeMedicine is a multi-agency government-industry partnership committed to strengthening Singapore's position as Asia's leading medical hub and international health care destination. Led by the Ministry of Health of Singapore, SingaporeMedicine is supported by three government agencies: the Economic Development Board, which develops industry capabilities, the International Enterprise Singapore, which fosters regionalism by Singapore-based health care players, and the Singapore Tourism Board, which markets Singapore as a healthcare destination to inbound international patients and develops associated people-oriented services. (


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