Robotic colorectal surgery in Singapore
Robotic colectomy and anterior resection, through a few small incisions.
Robotic-assisted colectomy and anterior resection remove an affected section of the colon or rectum through a few small incisions rather than one long opening. The surgeon controls the robotic arms from a console, using 3D visualisation and specialised instruments. Dr Sulaiman Bin Yusof is a Senior Consultant colorectal and general surgeon and sees patients at five clinics in Singapore.
FRCSEd (General Surgery)Five clinics in Singapore
In short
Console
Where the surgeon sits
The surgeon controls the robotic arms from a console, using 3D visualisation and specialised instruments to perform the procedure.
A few
Small incisions, not one opening
3 to 5
Days in hospital
Patients usually remain in hospital for 3 to 5 days after surgery. Early mobilisation typically begins within 24 hours.
Claimable
Insurance and corporate plans
For Singaporeans, Singapore Permanent Residents and foreigners. Please speak to our friendly clinic staff about using your insurance plans.
His story
Dr Sulaiman Bin Yusof
Senior Consultant Colorectal and General Surgeon, seeing patients at five clinics in Singapore.
- MBChB (Sheffield), M.Med (Surgery), FRCSEd (General Surgery)
- Consults in English and Malay
- MOH Fellowship, Peter MacCallum Cancer Centre, Melbourne
- Singapore Health Quality Service Star Award 2023
- Dean's Honour Roll for Teaching
What the operation involves
What the operation involves
3 to 5
Days in hospital
Source: Dr Sulaiman Bin Yusof, clinical practice
Asleep
General anaesthesia, monitored throughout
Ports placed
Small incisions for the robotic arms
The diseased section out
Vessels, nerves and nearby organs preserved
The bowel rejoined
Healthy ends reconnected, then closed
4 to 6
Weeks to normal activities
Source: Dr Sulaiman Bin Yusof, clinical practice
What it is
A section of bowel removed. Worked from a console.
Robotic-assisted colectomy and anterior resection are minimally invasive surgical techniques used to remove affected sections of the colon or rectum.
The surgeon controls robotic arms from a console, using 3D visualisation and specialised instruments to perform the procedure. This approach is one of the available surgical options for managing colorectal conditions and is conducted based on individual patient needs and clinical assessment.
One of several surgical options, chosen case by case
When it is used
Four reasons this operation gets recommended.
Robotic colectomy or anterior resection may be considered when non-surgical treatments do not provide sufficient relief. Conditions that may require these procedures include the following.
Colorectal cancer
Malignant tumours in the colon or rectum that require surgical removal. The extent of resection depends on the tumour's location and stage.
Diverticular disease
Severe or recurrent diverticulitis causing persistent symptoms or complications. Surgery involves removing the affected section of the colon.
Inflammatory bowel disease
Advanced ulcerative colitis or Crohn's disease that does not respond to medical treatment. Surgery may involve removing damaged portions of the bowel.
Large polyps
Benign growths that cannot be removed through colonoscopy. Surgical removal may be required to reduce the risk of malignant transformation.
What a polyp is, and why some can be taken out during a camera test while others cannot, is on the colon polyps page. What the camera test itself involves is on the colonoscopy page.
Why robotic
What the platform changes, and what it does not.
Robotic-assisted surgery offers several benefits compared with traditional open surgery. Compared with laparoscopic surgery, what changes is what the surgeon can see and how the instruments move.
3D vision and a wider range of motion
The robotic system provides 3D visualisation and an increased range of motion, allowing for precise dissection and suturing.
A few small incisions, not one long opening
The procedure typically requires only a few small incisions rather than a large opening, which may contribute to reduced post-operative discomfort and smaller scars.
A magnified, high-definition view
The robotic camera offers magnified, high-definition 3D images, aiding surgeons in identifying and preserving structures during surgery.
A shorter stay and a gradual return
This approach may allow for a shorter hospital stay and a gradual return to daily activities, depending on individual recovery.
Robotic or laparoscopic
Both are minimally invasive and both are done through small incisions rather than one long cut. Dr Sulaiman’s own position is that neither is superior in general: the right question is which approach gives the safest and most precise operation for your particular anatomy and disease, and the goal is always the operation rather than the instrument.
The largest randomised trial comparing the two, ROLARR (Jayne et al., JAMA 2017, 471 patients across 29 hospitals), found conversion to open surgery in 8.1% of robotic cases against 12.2% of laparoscopic cases, a difference that was not statistically significant. That is why the choice is made case by case at consultation rather than by rule, and why the deep pelvis, where access is tightest, is where the platform earns its place.
The keyhole version of the same operation, without the robotic arms, is on the laparoscopic anterior resection page, and where the segment lies further up the colon it becomes a laparoscopic hemicolectomy.
Preparing
Most of the preparation happens before you arrive.
Preparation for a robotic colectomy or anterior resection starts well before the day of surgery, and it runs in the following parts.
Medical evaluation
Pre-operative assessment includes blood tests, imaging studies, and cardiac evaluation if needed. The surgeon reviews the patient's complete medical history and current medications. This evaluation determines fitness for surgery and identifies potential risk factors.
Bowel preparation
Patients follow a clear liquid diet and take prescribed bowel cleansing solutions. The process begins 24 to 48 hours before surgery and gives a clean surgical field. Complete bowel emptying reduces the risk of infection and complications.
Medication adjustments
Blood thinners, certain supplements, and specific medications may need modification or cessation. Patients receive specific instructions about which medications to continue or stop before surgery.
In the weeks before
In the weeks before the procedure, patients may also be advised to stop smoking and adjust certain activities as part of pre-surgical preparation.
Fasting
Patients are required to fast for 6 to 8 hours before surgery.
24 to 48
Hours of bowel preparation
Source: Dr Sulaiman Bin Yusof, clinical practice
The operation
What actually happens once you are asleep.
A robotic colectomy or anterior resection runs through five steps, and they follow the same order every time.
Anaesthesia administration
General anaesthesia is administered, and vital signs are continuously monitored. Additional monitoring lines are placed as needed, and the patient is positioned appropriately for surgery.
Port placement
The surgeon creates small incisions in the abdomen for robotic arm ports. Camera and instrument ports are positioned strategically for optimal access. The abdomen is inflated with carbon dioxide to create working space.
Bowel mobilisation
The surgeon detaches the target segment of bowel from surrounding tissues. They identify and preserve blood vessels, nerves, and nearby organs. The robotic system allows detailed dissection along anatomical planes.
Resection and anastomosis
The diseased segment is removed through a small incision. The remaining healthy bowel ends are then reconnected using surgical staplers or sutures. The robotic system enhances precision and stability during this process.
Incision closure
All instruments are removed, and the incisions are closed with sutures. The surgeon ensures that there is no ongoing bleeding and that the reconnected bowel is secure before applying dressings to the incision sites.
Afterwards
Recovery, week by week, and what is watched.
Immediate care
Vital signs and pain levels are monitored in the recovery room. Intravenous fluids and pain medication are administered as needed. Early mobilisation typically begins within 24 hours to support recovery and reduce complications.
Patients usually remain in the hospital for 3 to 5 days after surgery. Bowel function is monitored, and pain is managed accordingly. A clear liquid diet is introduced first, gradually transitioning to solid food as bowel function recovers.
Recovery timeline
A gradual return to normal activities occurs over 4 to 6 weeks. Patients start with short walks and slowly increase activity levels. Specific guidelines on lifting restrictions and exercise limitations are provided.
Post-operative visits are scheduled to monitor healing. The surgeon examines wound sites and assesses overall recovery. Additional follow-up may be required depending on the condition treated.
2 to 4
Weeks before office-based work
Source: Dr Sulaiman Bin Yusof, clinical practice
Return to work, on a ten-week scale
- Office-based work
- 2 to 4 weeks
- Physical work
- 6 to 8 weeks
Source: Dr Sulaiman Bin Yusof, clinical practice
Risks and complications
The surgery carries risks, including bleeding, infection, and anaesthesia-related complications. Specific risks include anastomotic leak, which is a separation of the rejoined bowel segments, bowel obstruction, and temporary changes in bowel habits. Urinary or sexual function changes may occur due to nerve irritation in some cases.
Cost and insurance
What robotic bowel surgery can cost, before insurance steps in.
MOH's transacted bill data puts the median private-hospital inpatient bill at $58,411 for a minimally invasive anterior resection and $55,865 for a hemicolectomy, both including GST and before Medisave or insurance payouts. The middle half of anterior resection bills falls between $50,423 and $68,084, and hemicolectomy bills between $44,062 and $66,023.
Robotic surgery is one form of minimally invasive surgery, and the hemicolectomy benchmark pools keyhole and open operations, so neither figure is a robotic quote. Fees at the higher end tend to involve recurrent surgery, adhesions or more complex cases, and because bowel surgery is a planned admission, cover is worth settling early rather than on the day.
Who is covered
For Singaporeans, Singapore Permanent Residents and foreigners. Please speak to our friendly clinic staff about using your insurance plans.
Corporate insurance
Corporate insurance programmes are accepted, including extended panel arrangements. Which panel your own employer's plan sits on is something the clinic team will confirm for you before admission.
Integrated Shield Plans
Integrated Shield Plans are accepted. Speak to the clinic staff about using your plan, and about what your own policy requires, before the surgery is scheduled.
Common questions
The questions that come up before robotic bowel surgery.
When does bowel function come back?
Bowel function typically begins returning within 2 to 5 days after surgery. Initial patterns and frequency may vary, with full normalisation taking several weeks to months. Diet modifications and proper hydration help regulate bowel function during recovery.
When can I go back to work?
The timeline for returning to work depends on the individual's recovery and job requirements. Office-based work may resume in 2 to 4 weeks, while physically demanding jobs may require 6 to 8 weeks. The surgeon provides specific recommendations based on individual healing.
What does long-term recovery look like?
Long-term recovery varies. Some patients may notice changes in bowel habits, which typically stabilise over time. The long-term outlook depends on the condition treated, overall health, and adherence to post-surgical care recommendations.
Is robotic surgery better than laparoscopic surgery?
Not universally, and Dr Sulaiman does not argue that it is. For deep rectal work the robotic platform gives him real advantages in what he can see and how the instruments move in a narrow pelvis. For many colon operations laparoscopic surgery does the same job just as well. The trial evidence comparing the two is set out in the section above; the short version is that neither wins in general, which is why the choice is made case by case at consultation rather than decided in advance by the instrument.
Book a consultation
The platform is chosen for the operation. The operation starts with an assessment.
Consult Dr Sulaiman for an assessment and a personalised treatment plan. He sees patients at Gleneagles Medical Centre, Mount Elizabeth Novena Hospital, Parkway East Hospital, Mount Alvernia Hospital and Farrer Park Medical Centre.