RECTAL POLYPS / TUMOURS

Rectal polyps are protuberances in the inner lining of the bowel. The innermost lining of the musosa comprises of cells which overgrow and in doing so, heaps up on itself forming a surface elevation. The significance of polyps is that they can transform into cancer and this process accounts for 75% of colorectal cancers. The risk of transformation is proportional to size or the grade of dysplasia, i.e. the degree of abnormality in the behavior of surface mucosal cells that are clumped together.

Endorectal ultrasonography with 3D reconstruction

As with all ultrasound examinations, this technique uses a special probe which is capable of examining the individual layers of the bowel wall in great detail. When a polyp transforms into cancer, it means that the abnormal cells now burrow deeper, i.e. exhibit signs of invasion. The deeper the burrowing, i.e. through the layers of the bowel, the higher the T (tumor) stage. Through 3D reconstruction capabilities in endoanal ultrasound, patients benefit from a shorter examination time and hence increased comfort. At the same time, the visualization of the tumor in several dimensions allows for a more accurate staging of the tumor by our surgeons. By accurately identifying early tumors, we may be able to select appropriate patients for local treatment instead of large bowel resection surgery.
Transanal excision

This is a local excision technique of the tumor through the anus. By dilating the anus, the surgeon is able to locate a low rectal tumor (within 8-10cm from the outer edge of anus) and remove it using conventional instruments.
Transanal minimally invasive surgical resection

This is similar to transanal excision except that lesions are located higher up in rectum beyond the reach of conventional instruments. Using a special device, keyhole surgery is performed through the anus and the higher rectal tumor is removed from within. The defect is then sutured close.
Laparoscopic low anterior resection

This has been the standard of care offered by our surgeons. It is a minimally invasive technique of resecting segments of the colon or rectum. Restoration of bowel continuity can also be achieved through this. It has been proven to be associated with less postoperative pain, equivalent survival outcomes in cancer, shorter hospital stays and fewer complications such as pneumonia and wound infection. The conventional open form of surgery is still practiced but these are confined to selected cases whereby the laparoscopic techniques are not suitable. As patient selection is critical, do consult our surgeons who will provide you with a comprehensive explanation.
Robotic assisted laparoscopic low anterior resection

Under this variant of minimally invasive surgery, our surgeons perform the same laparoscopic techniques, except that the robot is controlled from the surgeon console which is situated away from the patient. This device confers the benefits of superior dexterity, decreased motion tremors, improved motion scaling, 3 dimensional optics and precision especially in the confined space of the pelvis. It is especially useful in the surgical resection of rectal tumours.