Laparoscopic surgery has come a long way since the first case of laparoscopic cholecystectomy was performed. The development is perhaps fastest in the surgical art of colorectal surgery. The initial years were mainly spent on developing and confirming the benefits of laparoscopic surgery. I have been performing laparoscopic colorectal surgery since 1997 and my aim in doing such surgery is help patients go through surgery with as little morbidity and as as few scars as possible.

Many laparoscopic surgeons use 4 to 5 ports routinely even in simple cases of colorectal resections. Currently, I have been championing the use of the 3 ports laparoscopic tehcnique. The use of the camera port at the umbilicus for extraction also decreases the number of wounds needed and this had helped to further improve the recovery and cosmesis of the patients undergoing such procedures. Most of my patients stay an average of 4 days in total in hospital and many are able to go shopping or even play golf at the end of two weeks. This is remarkable for an operation at in the not so good old days required at least 2 to 3 months recovery time.

This photograph show Prof Seow Choen in action with the use of 3 ports to remove a rectal cancer.

This photograph shows the three scars present at the end of a laparoscopic operation to remove a low rectal cancer in a middle aged man. There is an umbilical scar which had been extended to allow the removal of the large cancer and surrounding structures and two smaller scars on the right side of the abdomen used for the manipulative instruments.

Another good way to remove a right sided colonic cancer is to use the single port laparoscopic surgery. This involves the use of a device or even just a glove modified to allow instruments to pass all through a small hole and therefore the right colon with the surrounding structures and the cancer to be fully removed.

This photograph shows the end result of the removal of a right sided colonic cancer with the single port laparoscopic surgery. Only the small umbilical scar can be seen. Other innovations include the use of the umbilicus as the site for the defunctioning stoma following ultra low anterior resection, and ileo-anal pouch laparoscopic surgery which obviates what is often the longest and ugliest wound following these low rectal resection; that is the right iliac fossa stoma wound.

This photograph shows a patient who just had the entire colon taken out by laparoscopic surgery with 3 ports. The effect is remarkable and patients have great recovery and some patients are able to return to work at a week .

We have also experimented with the use of natural orifices for the extraction of the specimen(NOSE). I am not comfortable with this technique yet as there is still a huge problem with painful vagina during sex after the recovery period for these female patients.

Laparoscopic surgery is constantly changing and new ideas continue to sprout both from within our centre as well as learnt from other experts around the world. This allows me to do surgery more efficiently and the patients to recovery faster and with more assurance of cure and good results.

I have been teaching laparoscopic surgery all over the world and as all teachers know we learn much from our students as well!

An example of a letter from an appreciative host