Our Group is a medical services group primarily engaged in the provision of endoscopic procedures, including gastroscopies and colonoscopies, and general surgery services with a focus on colorectal procedures across a network of clinics located throughout Singapore.

The typical endoscopic procedures we perform include colonoscopy kiv polypectomy and gastroscopy. Endoscopic procedures can be either diagnostic or therapeutic, and can be used to identify and determine how we treat conditions of the digestive system. During the procedure, a variety of instruments can be passed through the endoscope in order to treat, among others, digestive problems, anal pain, constipation, diarrhoea and irritable bowel syndrome. Polypectomies may also be performed during the procedure in order to remove any polyps (growths) found in the lining of the intestine.

Other conditions treated by our Group include:

• haemorrhoids;
• anal abscesses;
• anal fissures;
• gallstones and inflammation of the gallbladder;
• hernias;
• colorectal cancer;
• stomach cancer;
• colonic diverticular disease; and
• cysts and lipomas.

Information on some of the typical endoscopic procedures we perform, the conditions we treat and related treatments commonly carried out by us are set out as follows:

Endoscopic Procedures

Endoscopic procedures can be either diagnostic or therapeutic, and can be used to identify and determine how best to treat conditions of the digestive system. During the procedure, a variety of instruments can be passed through the endoscope in order to treat, among others, digestive problems, anal pain, constipation, diarrhoea and irritable bowel syndrome.

Polypectomies may also be performed during the procedure in order to remove any polyps (growths) found in the lining of the intestine.

• + Colonoscopy kiv Polypectomy

  A colonoscopy is a common, safe procedure used to examine the entire length of the large intestine using an endoscope, a flexible fibreoptic tube with a light and camera attached. Colonoscopies are typically used as a diagnostic tool for screening, or for patients suffering from anal bleeding, changes in bowel habits, and abdominal pain, bloating or distention. It is also used to screen for various forms of cancer, including colorectal cancer. Colonoscopies can be used to detect polyps, colorectal bleeding, inflammation of the intestines, diverticular disease, haemorrhoids, anal fissures and anal fistulas.

   

  Colonoscopies are the only means by which excision of polyps located in the large intestines may be carried out. This is done by inserting various miniaturised tools through the scope to remove the polyps and prevent them from turning cancerous. The procedure is performed under intravenous sedation as a day procedure, and does not require hospitalisation.

   

• + Oesophagogastroduodenoscopies ('OGD' or 'gastroscopy')

  During an OGD or gastroscopy, a flexible fibreoptic scope with an attached light and camera is inserted via the mouth and pharynx into the oesophagus, stomach and duodenum. The patient is required to fast for at least six hours before the procedure, which is performed as a day procedure under intravenous sedation and occasionally in conjunction with a colonoscopy. OGDs are usually performed as a screening procedure, where patients are suffering from black stools, anal bleeding, abdominal pain or bloating, vomiting, foreign body obstruction (or food bolus), or where the patient has difficulty swallowing. The procedure can be used to detect ulcers of the stomach or duodenum, oesophagitis, gastritis, helicobacter infection resulting in gastritis ulcers and cancers, cancers of the stomach, oesophagus, duodenum, polyps and foreign bodies.

   

  OGDs are the only means by which excision of polyps and biopsies of lesions located in the oesophagus, stomach and duodenum may be carried out.

   

Other Conditions Treated and Related Treatments

• + Haemorrhoids

  Haemorrhoids are vascular channels which end in vascular cushions in the anal canal. Symptoms typically include bleeding, painful swelling or both. Non-surgical treatments include fibre supplements, anal ointments, oral medication, and rubber band ligation. Where these non-surgical treatments are ineffective to treat the condition, a haemorrhoidectomy may then be carried out. A haemorrhoidectomy is a procedure carried out under general anaesthetic to treat and excise the haemorrhoids.  

   

• + Anal Abscesses

  Fistulotomies are used to treat anal abscesses. An anal abscess, which can be an incapacitating condition, is caused by an infection in the anal canal due to an obstruction of the anal glands, resulting in the accumulation of pus. Patients with anal abscesses also tend to develop anal fistulas, which are abnormal tracts or tunnel-like lesions connecting the external skin abscess to the anal canal. This may involve only the internal sphincter, resulting in a low anal fistula, or it involves the external sphincter, which results in a high anal fistula. In the case of a low anal fistula, the procedure involves an incision being made to drain the accumulated pus and finding the fistula with a probe to lay open the tract. Where the case involves a high anal fistula, the procedure may need to be performed in two stages with a six-week interval in between. Fistulotomies may be carried out using local or general anaesthesia depending on the severity of the condition.  

   

• + Anal Fissures

  A lateral sphincterotomy is the current surgery of choice used to treat anal fissures. An anal fissure is a tear in the anal canal which is unable to heal due to a spastic internal anal sphincter, resulting in bleeding and pain when defaecating. Where the anal fissure cannot be treated using non-surgical treatments such as ointments, a lateral sphincterotomy is required. The operation is conducted under general anaesthesia, and involves making small cuts to the anal canal and sphincter to allow the anal fissure to heal.

   

• + Gallstones and Inflammation of the Gallbladder

  Gallbladder surgery, also known as a cholecystectomy, is used to remove gallstones or treat inflamed gallbladders. Symptoms of these conditions include upper abdominal pain and jaundice. The procedure may be carried out as a keyhole operation or by open surgery. Keyhole surgery is the most popular treatment of choice, with a significantly higher success rate than other forms of treatment. During the keyhole procedure, a laparoscope is used to remove the gallbladder, and the surgery is performed through several small incisions, each one inch or less in length, allowing for shorter recover times and less pain post-procedure. Where open surgery is performed, a large incision must be made on the abdominal wall from the ribs to just below the waist.  

   

• + Hernias

  Hernias are protrusions of an intestine or piece of tissue from its normally contained space, resulting in swelling of either or both inguinal regions. If left untreated, the size of the hernia may increase due to the small or large bowel having squeezed into the inguinal sac. Surgery is currently the only treatment available for hernias, and may be done as a keyhole procedure or by open surgery. During the keyhole surgery, several small incisions are made in the abdominal region. Instruments are then inserted through these incisions to repair the hernia, after which a mesh is placed over the defect to reinforce the abdominal wall. Keyhole surgery has been found to shorten recovery times and result in less pain post-procedure. If open surgery is performed, a single large incision is made in the abdomen where the hernia is located. The contents of the sac are emptied into the peritoneal cavity, after which the sac is excised. A mesh is then stitched onto the weakened area in the abdominal wall to reduce the risk of the hernia recurring, and the anterior muscle is stitched closed. The procedure may be performed as a day surgery.  

   

• + Colorectal Cancer

  Symptoms of colorectal cancer include blood in stools, diarrhea or constipation, abdominal distension, pain, weight loss and appetite loss. An individual's risk of developing colon cancer also depends on various factors including family history. Most cancers arise from polyps which, if not discovered in time and excised, gradually develop into cancer over a five to ten year period. At present, surgical resection remains the only available cure. The surgery involves a segmental resection of the affected region, whereby the affected piece of the colon or rectum is removed and the ends sewn back together. In certain cases where there is insufficient tissue on one side to sew the ends together, stoma creation may be necessary. On a case-by-case basis, we may refer patients with late stage colorectal cancers for chemotherapy and radiotherapy. 

   

  The procedure may be done as a keyhole procedure, open surgery or, most recently, via robotic surgery. Where keyhole surgery is performed, small incisions are made through which instruments are passed to perform the procedure, whereas open surgery involves a single large incision being made in the abdomen. Robotic surgery is a recent medical innovation during which the surgeon inserts the keyhole in the patient, but the instruments which are inserted through the keyhole are operated by a computer controlled by the surgeon. This enables the size of the keyhole to be minimized, which in turn reduces the length of the recovery period and lessens pain suffered post-procedure.

   

   

• + Stomach Cancer

  Gastrectomies are surgeries to treat stomach cancer. Symptoms of stomach cancer include abdominal pain, bloating, dark stools, loss of appetite and vomiting. A gastroscopy is used to diagnose the patient, after which a surgical resection of the affected section is required. The surgery may be a total or partial gastrectomy. A partial gastrectomy involves the removal of the lower half of the stomach, whereas a full gastrectomy involves the removal of the entire stomach, both to be carried out by way of open surgery. A third type of gastrectomy is the sleeve gastrectomy, during which the left side of the stomach is removed. This procedure is usually performed to assist with weight management and may be performed as a keyhole procedure.

   

  Gastrectomies may also be used to treat other stomach problems which cannot be cured using other treatments, such as benign tumors, bleeding, inflammation, perforations in the stomach wall or severe peptic or duodenal ulcers.

   

• + Colonic Diverticular Disease

  This disease results from small pockets of weaknesses in between the taenia coli of the colon muscle walls that allow protrusions of false diverticulum consisting of mucosa and submucosa. The disease commonly occurs in persons aged 40 and above, and symptoms include abdominal pain, peritonitis, fistula formations resulting in pneumaturia, obstructions and massive rectal bleeding. The disease is treated by resecting the affected segment followed by anastomosis or a temporary colostomy, as well as with antibiotics and a percutaneous drainage of any abscesses. This procedure can be performed as an open surgery or keyhole procedure.

   

• + Cysts and Lipomas

  Skin and subcutaneous cysts and lipomas that present themselves as lumps may be excised under anaesthesia. The procedure is a relatively short one, taking less than an hour, and may be performed as an outpatient day surgery.

   

Other General Surgery and Ancillary Services

We also provide general diagnostic and consultation services for patients as well. All of our clinics provide consultation services and are equipped to carry out a range of diagnostic tests including scans, x-rays and blood tests to assist in making an accurate diagnosis. In addition, our specialist surgeons have broad experience in general surgery and are capable of performing any surgical or medical procedures whether or not ancillary to endoscopic or related colorectal procedures, including, among others, unrelated procedures such as vascular surgery, renal transplants and treatments for thyroid conditions.

Orthopaedic Services

We also provide orthopaedic services as follows:

• Joint Pain (Shoulder/Elbow/Knee/Ankle/Spine)
• Sports Injuries
• Osteoarthritis
• Rotator Cuff Tears
• Trigger Finger
• Carpel Tunnel Syndrome
• Wounds/Lumps
• Joint Replacement (Knee/Shoulder/Elbow)
• Arthroscopic (Key-Hole) Surgery
• Fractures

House Calls

We also provide house call services for patients who wish to have consultation services on the endoscopic procedures and medical conditions treated by our Group at the comfort of the patient's home