Care at NUH

Division of Colorectal Surgery

2024/07/17

Colorectal Surgery Banner

Delivering Personalised Care 

The Division of Colorectal Surgery specialises in treating both malignant and benign conditions concerning the colon, rectum and anus. Our focus is on the early detection and treatment of colorectal cancer—the most prevalent cancer type in Singapore. 

Our approach to care is comprehensive and personalised, ensuring that both you and your loved ones receive a personalised treatment tailored specifically for your needs. Our consultant-led clinics operate from Monday to Friday, and your care will be managed by a dedicated specialist. 

If you or your loved ones have a confirmed diagnosis of colorectal cancer and wish to seek a second opinion, do contact us at our appointment line (+65 6908 2222).   

Our commitment is to schedule consultations with one of our specialists for all second opinion requests within 1 working day. 

Colorectal Cancer Symptoms Banner

If you experience the following symptoms, we encourage you to schedule an appointmentfor a consultation: 

  • Blood in the stool 
  • Sensation of incomplete emptying when passing motion 
  • New onset of constipation or diarrhoea 
  • Unintentional weight loss 
  • Family or personal history of colon cancer, endometrial (uterus) cancer, stomach cancer or small intestine cancer 
  • Personal history of colon polyps or inflammatory bowel disease 

 

Colorectal Surgeon Banner

Colorectal cancer is curable if detected early. However, individuals with colon polyps or early colon cancer may not display any symptoms. We encourage all patients above the age of 50 to undergo regular colorectal cancer screening. There are two common screening methods in Singapore: 

 

FaecalImmunohistochemical Test (FIT) 

The FIT is designed to detect blood in the stool that might not be visible to the naked eye. The FIT kit comes with a stick used to collect a small sample of stool. This test is not suitable if you are already passing blood in your stools. 


Faecal Immunohistochemical Test

Colonoscopy 

A colonoscopy is the 'gold standard' for colorectal cancer screening. The doctor uses an endoscope—a flexible tube with a camera—to evaluate the inner lining of the colon and rectum. During the colonoscopy, any identified polyps or areas of concern are removed and sent for microscopic evaluation. This serves a dual purpose of both diagnosing any potential issues and providing therapeutic intervention, as some polyps have the potential to develop into cancer.


Colonoscopy

If you or your loved ones have a history of the following conditions, you may require screening before the age of 50. Click here to schedule an appointment with us. 
 

  • Colon polyps 
  • Personal or family history of colon cancer 
  • Inflammatory bowel disease (ulcerative colitis or Crohn’s disease) 
  • Genetic diseases such as familial adenomatous polyposis and Lynch syndrome  

 

Colorectal Cancer Symptoms Question Banner

Constipation or diarrhoea

Normal bowel movements differ between people. Some may have up to three bowel movements a day, while others may go days between movements. Constipation can result from various factors like insufficient water intake, low fibre consumption, and lack of physical activity. Additionally, medical conditions such as high calcium levels or hormonal imbalances might contribute to constipation. 

 

Diarrhoea is most commonly due to benign causes, such as a viral infection (gastroenteritis) or lactose intolerance, particularly common among Asians. However, persistent diarrhoea should prompt evaluation for more serious underlying causes, such as chronic infectious causes, inflammatory bowel disease and spurious diarrhoea from colorectal cancer. 

If you have new-onset constipation that is persistent, you should undergo evaluation, including colonoscopy for colorectal cancer.  

Anal Pain 

Pain around the anus commonly occurs due to anal fissures, which are traumatic tears around the anus due to the passage of hard stools. Treatment usually includes stool softeners, painkillers and medication to relieve the associated spasm in the anal sphincter muscles. 

Pain around the anus may also be due to prolapsed or thrombosed haemorrhoids. These are initially treated with stool softeners and topical anaesthetic agents, while surgery may be indicated once the acute event has settled down. 

Anal pain associated with discharge and fever may indicate perianal abscesses or anal fistulas. These can be treated with antibiotics but may require surgery for definitive management.  

Incontinence

 

Incontinence 
Faecal incontinence can be a distressing symptom as it may manifest as passive seepage of solid or liquid stools or an inability to reach the toilet in time during periods of urgency. Incontinence is commonly associated with a history of obstetric trauma or previous anal surgery. 

 

Our Services Banner

The Division of Colorectal Surgery offers an extensive range of up-to-date medical treatment, clinic-based therapies and surgical procedures to our patients. 

Minimally Invasive Surgery

Minimally Invasive Surgery 
 

Laparoscopic (keyhole) surgery: This approach involves small incisions in the abdomen using special instruments under general anaesthesia. It is an advanced technique that avoids the need for large incisions, reducing post-operative discomfort, minimising the risk of wound infections and shortening hospital stays. 

Robotic surgery: This method involves small incisions in the abdomen and the use of surgeon-controlled robotic arms under general anaesthesia. The benefits are similar to those of laparoscopic surgery.  

Transanal Surgery

Transanal Surgery 

 

Transanal Minimally Invasive Surgery (TAMIS) uses a specialised platform to remove growths from the mid to upper rectum. It eliminates the need for major abdominal surgery for large polyps or early rectal cancers. 

Transanal Total Mesorectal Excision (taTME) is a novel surgical approach for the treatment of rectal cancer. Two surgical teams work in tandem, using a combined abdominal and transanal approach to remove low rectal cancers.  

Advanced Endoscopy

Advanced Endoscopy 

​Previously, large colon polyps required a resection of the colon for complete removal. These days, advanced endoscopic resection techniques such as Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) allow patients to avoid surgery. 

 

Peritoneal based therapies

Cytoreductive Surgery (CRS) and Heated Intra-peritoneal Chemotherapy (HIPEC) 
​Patients with advanced cancers affecting the peritoneum may be treated with CRS and HIPEC, which involve the resection of all visible cancer and delivery of heated chemotherapy directly into the abdominal cavity. 


Pressurised Intra-Peritoneal Aerosolised Chemotherapy (PIPAC) 
PIPAC is a novel, promising technology for the treatment of patients with advanced peritoneum cancer. Chemotherapy is administered in an aerosolised form into the abdominal cavity using laparoscopic (keyhole) techniques. 

 

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Conditions
  • Anal fissures - tear or split in the lining of the large intestine, near the anus
  • Anorectal abscesses and fistulas - collection of pus in the area of the anus and rectum
  • Colorectal cancer - cancer cells that are present in the colon or rectum
  • Constipation - occurs when bowel movements become less frequent, and stools become difficult to pass
  • Haemorrhoids - swelling or lumps found inside and around the anus (also known as piles)
  • Incontinence - occurs when stool or gas cannot be controlled
Our Team
  • Associate Professor Tan Ker Kan

    Head of Department
    Senior Consultant

    Sub-specialties: Colorectal Surgery, Surgical Oncology (Colorectal Surgery)
    Special interests: Colorectal cancer, Key-Hole/Laparoscopic surgery, Anal fistula, Haemorrhoids, Colonoscopy

    To book an appointment with this surgeon, click here

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Cheong Wai Kit
    Adj A/Prof Cheong Wai Kit

    Senior Consultant

    Sub-specialties: Colorectal Surgery, Surgical Oncology (Colorectal Surgery)
    Special interests: Recurrent and advanced colorectal cancer, Diagnostic and therapeutic endoscopy

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Assistant Professor Bettina Lieske
    Assistant Professor Bettina Lieske

    Senior Consultant

    Sub-specialties: Colorectal Surgery, Surgical Oncology, Surgical Oncology (Colorectal Surgery)
    Special interests: Diagnostic and Therapeutic Endoscopy (Gastroscopy and Colonoscopy), Laparoscopic Surgery for Colorectal Cancer and Benign Colorectal Conditions, Malignant Peritoneal Disease (Including Neoplasms of the Appendix & Pseudomyxoma Peritonei), Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy (CRS and HIPEC), Pressurised Intraperitoneal Aerosolised Chemotherapy (PIPAC)

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Ian Tan
    Dr Ian Tan

    Consultant

    Sub-specialties: Colorectal Surgery
    Special interests: Colorectal Cancer, Diagnostic and Therapeutic Endoscopy (Gastroscopy and Colonoscopy), Minimally Invasive Surgery, Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease)

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Ng Jing Yu
    Dr Ng Jing Yu

    Consultant

    Sub-specialties: Colorectal Surgery, General Surgery, Minimally Invasive Surgery
    Special interests: Colorectal Surgery, Minimally Invasive Surgery, Transanal Minimally Invasive Surgery (TAMIS), Transanal Total Mesorectal Excision (taTME)

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Dedrick Chan
    Dr Dedrick Chan

    Consultant

    Sub-specialties:Colorectal Surgery
    Special interests: Oncologic Surgery, Minimally Invasive Approaches, Colonoscopy

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Norman Lin
    Dr Norman Lin

    Consultant

    Sub-specialties:Colorectal Surgery, Trauma Surgery
    Special interests: Colorectal Cancer, Minimally Invasive/Laparoscopic Surgery, Colonoscopy, Haemorrhoids

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Lee Kai Yin
    Dr Lee Kai Yin

    Consultant

    Sub-specialties:Colorectal Surgery, Surgical Oncology (Colorectal Surgery
    Special interests: Colorectal Cancer, Minimally Invasive/Laparoscopic Surgery, Colonoscopy, Haemorrhoids

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Bryan Buan Jun Liang
    Dr Bryan Buan Jun Liang

    Associate Consultant

    Sub-specialties:Colorectal Surgery, Surgical Oncology (Colorectal Surgery
    Special interests: Colorectal Cancer, Minimally Invasive Surgery, Diagnostic and Therapeutic Endoscopy, Haemorrhoids

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

  • Dr Jarrod Tan Kah Hwee
    Dr Jarrod Tan Kah Hwee

    Associate Consultant

    Sub-specialties:Colorectal Surgery, Surgical Oncology (Colorectal Surgery, Minimally Invasive Surgery
    Special interests: Colorectal Surgery, Minimally Invasive Surgery, Colonoscopy, Haemorrhoids, Anal Fistula

    To book an appointment with this surgeon, clickhere

    Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

Our Experience

Our Experiences Banner

We adopt best practices and measure our performance comparing to international benchmarks.

Laparoscopic Colon Resections

 NUH (2020 up to Q3/2022)International Benchmarks 1-5
Anastomotic leak1.3%4 - 7%
Conversion to open surgery1.6%0 - 6%
Wound infection1.3%0 - 4%
Thromboembolic rates 01.5 - 4.3%
Severe complications (Clavien Dindo ≥3)1.2%1 - 8.8%
Length of stay (days)6.73 - 8
Readmission rates1.2%0 - 7.3%
Mortality00 - 3.5%

Laparoscopic Rectal Resections

 NUH (2020 up to Q3/2022)International Benchmarks 4-7
Anastomotic leak3.1%9.8%
Conversion to open surgery3.4%7.6%
Wound infection3.1%0.9 - 2.6%
Severe complications (Clavien Dindo ≥3)3.1%12.2%
Thromboembolic rates 3.1%1.5 - 4.3%
Length of stay (days)8.54 - 10
Readmission rates6.7%15.3%
Mortality3.1%0 - 3.7%
References:

1. Staiger, R. D., Rössler, F., Kim, M. J, et al. (2022). Benchmarks in colorectal surgery: multinational study to define quality thresholds in high and low anterior resection. The British journal of surgery, znac300. Advance online publication. https://doi-org.libproxy1.nus.edu.sg/10.1093/bjs/znac300

2. Wang, Y., Deng, H., Mou, T. et al. Short-term outcomes of single-incision plus one-port laparoscopic versus conventional laparoscopic surgery for rectosigmoid cancer: a randomized controlled trial. Surg Endosc 33, 840-848 (2019).

3. Peltrini, R., Imperatore, N., Carannante, F. et al. Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients. Updates Surg 73, 527-537 (2021). https://doi.org/10.1007/s13304-021-00990-z

4. Hayes, J. W., Ryan, É. J., Boland, P. A., Creavin, B., Kelly, M. E., & Beddy, D. (2019). The prevalence of venous thromboembolism in rectal surgery: a systematic review and meta-analysis. International journal of colorectal disease, 34(5), 849-860. https://doi.org/10.1007/s00384-019-03244-y

5. Ali, F., Al-Kindi, S. G., Blank, J. J., Peterson, C. Y., Ludwig, K. A., & Ridolfi, T. J. (2018). Elevated Venous Thromboembolism Risk Following Colectomy for IBD Is Equal to Those for Colorectal Cancer for Ninety Days After Surgery. Diseases of the colon and rectum, 61(3), 375-381. https://doi.org/10.1097/DCR.0000000000001036

6. Bollo, J., Turrado, V., Rabal, A., et al. (2020). Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial). The British journal of surgery, 107(4), 364-372. https://doi.org/10.1002/bjs.11389

7. Cleary, R.K., Silviera, M., Reidy, T.J. et al. (2022). Intracorporeal and extracorporeal anastomosis for robotic-assisted and laparoscopic right colectomy: short-term outcomes of a multi-center prospective trial. Surg Endosc 36, 4349-4358. https://doi.org/10.1007/s00464-021-08780-9

Spotlight on Colorectal Cancer

Click on the pictures below to read the full article.

NUH Colorectal Surgery in the Media

16 March 2021

The Straits Times © SPH Media Limited. Reproduced with permission

16 March 2021 article

16 May 2017

The Straits Times © SPH Media Limited. Reproduced with permission

16 May 2017 article
(PDF, 135 KB)

14 October 2022

The Straits Times © SPH Media Limited. Reproduced with permission

14 October 2022 article

25 March 2021

25 March 2021 article

Our patients shared their stories on their journey with colorectal cancer:

1 August 2017

The Straits Times © SPH Media Limited. Reproduced with permission

1 August 2017 article

2 April 2018

The Straits Times © SPH Media Limited. Reproduced with permission

2 April 2018 article

Past events

26 March 2022 - NUH Colorectal Public Webinar

NUH Colorectal Public Webinar

 

25 September 2021 - NUH Colorectal GP CME Webinar

NUH Colorectal GP CME Webinar

 

27 March 2021 - NUH Colorectal Public Webinar

NUH Colorectal Public Webinar

 

20 March 2021 - NUH Colorectal GP CME Webinar

NUH Colorectal GP CME Webinar

 

Charges & Fees

Insurance
Our surgeons are included in all major Singapore insurance panels. You may find out more from our Financial Counselling staff during your visit to us.

Estimated Charges
Below estimates are for Class A / Foreign patients following an uncomplicated post-operative recovery. Class B and C patients enjoy further government subsidies; you may find out more during your Financial Counselling visit to us.

Estimated Total Bill Size for Singaporean (5 day stay)
Laparoscopic Colon Resection$12,702.00 - $19,880.00
Laparoscopic Rectal Resection$17,726.00 - $21,978.00
Estimated Total Bill Size for Non-Resident (5 day stay)
Laparoscopic Colon Resection$29,063.00 - $38,239.00
Laparoscopic Rectal Resection$25,878.00 - $52,274.00

Disclaimer: Information is reflected correctly as at 5 January 2023. For more information, click here.

Clinical Fellowship

Honorary Clinical Fellowship in Colorectal Surgery 

The NUH Division of Colorectal Surgery offers a Clinical Fellowship in Colorectal Surgery for clinicians interested in gaining exposure and deepening clinical expertise in Colorectal Surgery. Up to two fellowship positions are available per year, with a specialised training programme of 12 months. More details can be found here.

For enquiries, please email [email protected] with the subject header “Colorectal Fellowship” addressed to Asst Prof Bettina Lieske.  For more information about the application process for NUHS Clinical Fellowships, please click here.

Contact Us
16b Colorectal Centre
16b Colorectal Centre

Location

NUH Medical Centre, Zone B, Level 16

Opening Hours
Mon - Fri: 8.30am to 5.30pm
Sat, Sun & PH: Closed

Contact
+65 6908 2222 (general appointment line)
+65 6772 2230
[email protected]

For booking of appointment with the surgeon of your choice, please click here to make an appointment.

Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg

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