Robotic Surgery in Singapore

Robotic surgery, also known as robot-assisted surgery, is a minimally invasive surgical technique where surgeons use specialised robotic systems to perform procedures. The surgeon controls robotic instruments from a console, translating their hand movements into precise micro-movements of surgical instruments inside the patient’s body. This approach combines the surgeon’s expertise with enhanced visualisation and instrument dexterity.

The robotic system consists of three main components: a surgeon’s console where the surgeon sits and controls the instruments, a patient-side cart with robotic arms that hold surgical instruments, and a high-definition 3D vision system. The surgeon maintains complete control throughout the procedure, with the robotic system serving as an extension of their hands. This technology allows for procedures to be performed through incisions as small as 8-12mm, compared to traditional open surgery that may require incisions of 15-20cm or more.

Robotic surgery is used across multiple surgical specialties including urology, gynaecology, general surgery, cardiothoracic surgery, and colorectal surgery. Common procedures performed robotically include prostatectomy, hysterectomy, hernia repair, gallbladder removal, and certain cardiac procedures.

• Single-Site Robotic Surgery: Single-site robotic surgery involves performing the entire procedure through one small incision, typically at the umbilicus (belly button). This technique is useful for gallbladder removal, certain gynaecological procedures, and some urological surgeries. The specialised instruments and camera all work through this single entry point, resulting in virtually scarless surgery.
• Multi-Port Robotic Surgery: The most common approach involves creating several small incisions (ports) through which robotic instruments and the camera are inserted. Typically, 3-5 ports are used, each measuring 8-12mm. This configuration provides triangulation for the instruments and allows the surgeon to approach the surgical site from multiple angles, ensuring comprehensive visualisation and access.
• Technology & Equipment Used: Modern robotic surgical systems feature high-definition 3D cameras that provide magnified views of the surgical field, up to 10 times greater than the human eye. The robotic instruments have seven degrees of freedom, exceeding the capabilities of the human wrist, allowing for precise dissection and suturing in confined spaces. The systems incorporate tremor filtration, eliminating any natural hand tremor and enabling steady, controlled movements. Motion scaling allows large hand movements at the console to be translated into smaller, more precise movements inside the patient.

Robotic surgery offers numerous evidence-based advantages for suitable patients. The minimally invasive approach results in less blood loss during surgery, reducing the need for transfusions. Smaller incisions mean less post-operative pain, allowing patients to mobilise sooner and require fewer pain medications. Hospital stays are typically shorter, with many procedures performed as day surgery or requiring only overnight admission.

The enhanced visualisation and precision of robotic systems can lead to preservation of healthy tissue and important structures like nerves and blood vessels. This is valuable in procedures like prostate surgery where nerve preservation affects continence and sexual function. The magnified 3D view allows surgeons to see anatomical details not visible to the naked eye.

Recovery times are generally faster, with patients returning to normal activities weeks earlier than after open surgery. The cosmetic results are good, with several small scars rather than one large incision. This can be important for younger patients or those concerned about scarring. Studies have shown comparable or improved clinical outcomes with robotic surgery for many procedures, with the added benefits of the minimally invasive approach.

Robotic surgery costs in Singapore reflect the technology and specialised expertise involved. Factors affecting total costs include the specific procedure performed, operating time required, hospital stay duration, and any additional treatments needed. The investment covers the surgery itself, the specialised equipment, trained surgical team, and comprehensive pre and post-operative care.

While robotic surgery may have higher upfront costs than traditional surgery, the overall value includes shorter hospital stays, faster recovery, reduced time off work, and potentially fewer complications. Many patients find the benefits of minimally invasive surgery justify the investment. Consultation with the surgical team provides personalised cost estimates based on individual treatment needs. Payment plans may be available to help manage expenses.