Colorectal Surgery

Hills Colorectal Surgery deals with all types of colorectal problems such as bowel cancer, inflammatory bowel disease, diverticular disease, anorectal problems and pelvic floor disorder.

Bowel diseases include benign polyps, bowel cancer, inflammatory bowel disease, ischaemic bowels and diverticular disease. Anorectal problems include haemorrhoids, anal fissure, anal fistula, perianal abscess, rectal prolapse and anal cancer. Pelvic floor disorders include faecal incontinence, obstructed defecation and internal rectal prolapse. Common symptoms that are related to a colorectal problem include: bowel bleeding, abdominal pain, constipation or diarrhoea, anal pain, anal itchiness and anal lumps.

In addition, we also provide screening colonoscopy for the general population and for patients with higher risk of developing colorectal cancer such as those people with positive faecal occult blood tests (FOBT), family history of bowel cancer and genetically related bowel cancer in the family.

We use the most recent knowledge and proven technology to provide the highest quality of care in the management of these diseases.

TAMIS (TransAnal Minimally Invasive Surgery)

This is a technique first described by Drs S Atallah, M Albert, S Larach in 2009. It involves the use of a device that allows introduction of laparoscopic instruments into the anal canal without losing the gas in the rectum (pneumorectum). Carbon dioxide gas (CO2) is pumped into the rectum via a tube in the device to provide the distension necessary for visualisation as in abdominal laparoscopic operation. The device is inserted by applying steady manual pressure. Once seated in position, pneumorectum is established and laparoscopic instruments including graspers, thermal energy devices and needle holders can be inserted via the device (port) to perform the transanal excision. The device that Dr Chew used is Gelpoint made by Applied Medical.

Dr Chew uses this procedure for large polyps (larger than 3 cm) in mid and low rectum. However, he does not use this technique for known malignant tumour (proven by biopsy). The photographs demonstrate the different stages of polyp removal via this minimally invasive approach.

Large-polyp---colonoscopic-view
Large polyp – Colonoscopic view
Large-polyp---TAMIS-view
Large polyp – TAMIS view
Polyp-removed---wound-exposed
Polyp removed – Wound exposed
Suturing-of-wound
Suturing of wound
Closed-wound
Closed Wound