“Robotic surgery in gynaecology is the fastest growing area in robotic surgery outstripping robotic prostatectomy. This is because there are many more gynaecological procedures that can be performed robotically in the female pelvis.”
Our surgical technique is driven by providing what is best for our patients. Dr. Suresh Nair has extensive experience in advanced laparoscopic and hysteroscopic surgery and has been the pioneer in robot-assisted laparoscopic gynaecological surgery in Singapore. He has performed many complicated surgeries for severe endometriosis, multiple large fibroids and advanced pelvic gynaecological, urological incontinence, pelvic floor reconstruction and oncological surgery.
Laparoscopy is a surgical technique that enables the physician to examine the abdomen and pelvis by inserting a laparoscope (a thin fiberoptic tube with a camera at the end) through a small incision in the navel. Laparoscopy is a powerful diagnostic tool, allowing physicians to see problems which often are not detectable by a physical examination or ultrasound. Many conditions—such as tubal blockage, ovarian cysts, pelvic adhesions, uterine fibroids or endometriosis—can be treated by laparoscopy during the same surgery.
In addition, our surgeons are nationally and internationally recognized for performing advanced laparoscopic surgeries for hysterectomy (removal of large uterus due to fibroids) and extensive endometriosis.
Hysteroscopy is a surgical technique that allows the physician to examine the uterine cavity using a small scope (camera) inserted into the uterus. While performing a hysteroscopy, the physician is able to remove fibroids, polyps and repair any scarring that may have resulted from prior uterine surgeries. All of these conditions, if left untreated, can lower the chances of both natural conception and conception using fertility treatments.
As with laparoscopy, patients usually need minimal recovery time after a hysteroscopic procedure.
Robot-Assisted Laparoscopic Surgery
The Hospital’s state-of-the-art equipment includes da Vinci surgical robots that allow the surgeon to perform complex operations through small incisions—so-called “robot-assisted surgery.”
Dr. Suresh Nair is highly skilled in managing a wide range of advanced robotic-assisted procedures. For more than a decade, he has been performing minimally invasive robotic surgery to treat multiple gynaecological issues including severe endometriosis, multiple large fibroids and advanced pelvic gynaecological, urological incontinence, pelvic floor reconstructive and oncological surgery.
A team of specialized physician assistants, nurses, surgical technicians, and anesthesiologists supports him during every procedure.
His extensive experience and access to the most advanced robotic technology available allows him to offer procedures to manage many complex conditions. He is able to perform surgery with pinpoint accuracy, ensuring the best possible result for each patient.
The robotic procedures he performs include the following:
- Hysterectomy for benign and cancerous conditions of the uterus.
- Myomectomy, or removal of uterine fibroids.
- Treatment of endometriosis as part of female infertility workup.
- Chronic pelvic pain.
- Uterine bleeding.
- Uterine prolapse
Robotic surgery at Mt. Elizabeth Novena Hospital is performed in dedicated operating theatres using one of our seven state-of-the-art da Vinci® surgical systems. These units include advanced infrared imaging and dual consoles on which surgeons can work collaboratively.
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Robotic surgery is a type of minimally invasive surgery during which the doctor use very small surgical instruments that fit into a patient’s body through a series of tiny incisions.
These instruments are mounted on three robotic arms, allowing the surgeon maximum range and precision of motion as he performs the procedure. A fourth arm holds a high-definition, three-dimensional camera that enhances visualization—magnifying the tissue and structures of the body tenfold—and guides the surgeon during the procedure.
“Our goal is to manage the condition and alleviate the pain and suffering of our patients while preserving fertility.”
Because robotic surgery requires very small incisions, appropriately selected patients can benefit from less surgical trauma, minimal scarring, and faster recovery times than with traditional open surgery.
The Da Vinci robot has a number of major advantages namely:
Stereoscopic three dimensional vision which gives the surgeon more depth perception compared to two dimensional laparoscopy.
Instruments that articulate and can be moved with fingertip precision and is termed the “endowrist” technology which allows 720 degrees range of movement with 7 degrees of freedom of movement which makes it multiple times more versatile compared to regular laparoscopy. The robotic instruments are comparable to having a miniaturized human hand through only an 8 mm incision through the abdomen.
Ability to do a high precision micro-surgery with the technology called motion-scaling where moving the instrument 1 cm can be scaled down into precision movement of 5mm. This is particularly useful in stitching ultra-small structures like the fallopian tube.
Tremor filtration: this is a facility that enables the surgeon to do fine precisions surgery and stitching without the physiological tremor.
It enables the surgeon to operate seated comfortably behind a console and to do long surgeries with minimal fatigue. In laparoscopy, the instruments are hand held at a long distance from the active movement of the instrument tips with the surgeon’s arms and elbows raised across the patient making it awkward to operate especially in confined spaces and long surgeries.
Furthermore, in laparoscopy the surgeon has to work opposite as to what is required because if he wants to move the tip of the instrument from right to left his brain has to think the opposite direction and move the upper end of the instruments he holds from left to right. This is counter-intuitive and can hamper the easy performance of complicated tasks like stitching and operations requiring high level of surgical skill. The robotic system is “intuitive” meaning the surgeon moves his hand which controls the micromanipulators of the robot and operates in the same way as open surgery with movements that are routine in daily life.