Colorectal surgery focuses on the treatment of diseases affecting the lower gastrointestinal tract, including the colon, rectum, and anus. These conditions range from benign issues such as haemorrhoids and anal fistulas to more aggressive diseases such as inflammatory bowel disease and colorectal cancer. Generally, colorectal surgery aims to remove damaged sections or obstructions caused by these diseases and restore bowel function.
An Overview of the Two Surgical Techniques
Laparoscopic Colorectal Surgery
Also known as keyhole surgery, this minimally invasive technique involves a few small incisions. A laparoscope (a camera-equipped tube) and specialised instruments are inserted to allow the surgeon to operate while viewing real-time images on a monitor. It is often used for diagnostic and therapeutic procedures in the abdomen.
Open Colorectal Surgery
This traditional approach uses a single large incision to give the surgeon direct access to the affected area. It may be necessary in complex cases, such as those involving extensive disease, prior abdominal surgery, or challenging anatomy.
Benefits of Laparoscopic Colorectal Surgery
Laparoscopic colorectal surgery offers several advantages that make it a preferred option for many patients undergoing planned or early-stage procedures.
- Smaller Incisions, Less Pain — The small incisions result in reduced trauma to surrounding tissue, leading to less postoperative pain and smaller, less visible scars.
- Faster Recovery and Shorter Hospital Stay — Patients typically recover more quickly and spend less time in the hospital, which allows for a faster return to daily activities.
- Lower Risk of Wound Infections — Smaller wounds carry a reduced risk of infection, which may lead to fewer postoperative complications and less need for antibiotics.
- Minimal Blood Loss — The precision of laparoscopic tools helps limit blood loss during surgery, which is particularly beneficial for patients with bleeding concerns.
Benefits of Open Colorectal Surgery
Open colorectal surgery is a time-tested method remains essential for certain complex or urgent cases.
- Suitable for Complex or Emergency Cases — Open surgery offers better access and flexibility, making it the preferred option for treating large tumours, severe inflammation, or complications like bleeding or obstruction.
- Better Visualisation and Control — Surgeons benefit from a direct view and the ability to feel tissues, which can be critical during complex procedures involving scar tissue or unusual anatomy.
- Potentially Lower Cost — As it does not rely on specialised laparoscopic instruments or advanced operating room equipment, open surgery may be a more cost-effective option in certain cases.
Factors Influencing the Choice of Surgery
Choosing between laparoscopic and open colorectal surgery is not always straightforward. It is a decision influenced by several factors, including:
- Overall Health and Medical History — The patient's health status determines the appropriate surgical approach. Factors such as obesity, heart or lung conditions, or a history of abdominal surgeries may make laparoscopic surgery more challenging.
- Type and Stage of Colorectal Disease — Both laparoscopic and open techniques can treat a range of colorectal conditions. However, open surgery may be preferred in more advanced or complex cases, such as large tumours or widespread disease.
- Surgeon’s Experience — The surgeon’s experience is essential regardless of the approach. Laparoscopic surgery requires advanced technical skills and specialised training.
- Emergency vs Planned Surgery — During emergencies, open surgery is often recommended for faster access. For elective procedures, there is typically more flexibility to choose the best method based on individual circumstances.
- Individual Anatomy — Each patient’s anatomy is unique. Factors like adhesions or unusual bowel positioning may influence the decision and affect how well laparoscopic techniques can be used.
Laparoscopic colorectal surgery offers less invasiveness, quicker recovery, and reduced postoperative pain. However, this approach is not always suitable. More complex cases often necessitate traditional open surgery for accurate examination and treatment.
Ultimately, the decision should be a collaboration between you and your surgeon. Discuss your concerns and ask for specific details about each procedure, including recovery time, potential complications, and expected long-term outcomes.
Schedule a consultation with our colorectal specialist today to find out which surgical option is right for you and get tailored treatment recommendations for your needs.
Our Colorectal Surgeons
Dr Dennis Koh
Medical Director & Senior Consultant Surgeon
B Med Sci (Nottingham), MBBS (Nottingham)
MMed (Surgery), FRCS (Edinburgh), FAMS
Dr Dennis Koh is a MOH-accredited and experienced colorectal surgeon with specialised expertise in the management and treatment of colorectal cancer; and currently the Medical Director at Colorectal Practice.
Dr Koh strives to provide a customized treatment plan for each patient, which allows for better outcomes. He also honed his skills in proctology abRd in Geneva, bringing a more diverse touch to his practice.
Dr Sharon Koh Zhiling
Senior Consultant Surgeon
MBBS (Singapore), MMed (Surgery),
FRCS (Edinburgh), FAMS
Dr Sharon Koh is an experienced colorectal surgeon and the former Director of Endoscopy at Alexandra Health. She has subspecialty training in colorectal surgery, minimally invasive surgery, and advanced endoscopy — particularly in the field of colorectal cancer.
Dr Koh completed her fellowship at Cedars-Sinai Medical Centre in the US after being awarded the Academic Medicine Development Award by the National University Hospital.
Dr Pauleon Tan Enjiu
Senior Consultant Surgeon
MBBS (Singapore), MMed (Surgery),
FRCS (Edinburgh), FACS
Dr Pauleon Tan has served in public hospitals for over 15 years and is experienced in minimally invasive surgery and endoscopy. He is also experienced in the treatment for colorectal cancer, and strives to provide the best possible care to his patients.
Dr Tan undertook advanced colorectal surgical training at Japan’s Saitama International Medical Center after being awarded the Ministry of Health – Health Manpower Development Plan (HMDP) Award.