RSIM General and Colorectal Surgery is conveniently located at Farrer Park Medical Centre, Farrer Park Station Road, Singapore. The clinic specializes in the diagnosis and treatment of various colorectal diseases using minimally invasive endoscopic-laparoscopic techniques. To ensure the best possible outcome, the clinic uses state-of-the-art technologies and scientifically proven techniques that aim to make each procedure more comfortable and significantly reduce recovery time so patients are able to get back on their feet as soon as possible.
RSIM General and Colorectal Surgery is headed by Dr. Richard Sim, who boasts an impressive reputation in his chosen field. He is a Senior Consultant General and Colorectal Surgeon with a keen interest in minimally invasive procedures and enhanced recovery protocols. He is currently an Honorary Secretary of the ASEAN Society of Colorectal Surgeons and was previously the President of the Society of Colorectal Surgeons in Singapore. Trusted not just by patients by also by his peers, he made significant contributions to the MOH Guidelines for the Management of Colon and Rectal Cancers. He believes in the importance of patient empowerment and devotes his extra time to raising public awareness about diseases that affect the colon.
Dr. Sim was also previously the Senior Consultant and Head of Colorectal Unit, Director of Surgical Training, and Director of Centre for Advanced Laparoscopic Surgery at Tan Tock Seng Hospital. This is the first centre outside the United States to be accredited by Society of American Gastrointestinal and Endoscopic Surgeons.
Dr. Richard Sim, an SMC-certified surgeon specializing in gastrointestinal and colorectal procedures, is committed to the pursuit of excellence in his practice. He believes that surgeons like himself can immensely improve their practice by constantly tracking their own results to provide quality service to all patients. He also believes in a personalized approach aside from providing highly advanced treatment options.
An Appendicectomy, also called as an Appendectomy, is a surgical procedure to remove the appendix because of a condition called acute appendicitis. Most appendectomies are performed as emergency procedures. Appendectomies can be performed using the open surgery method or through a laparoscopy. In an open surgery, an incision is created in the right lower quadrant of the abdomen and the appendix is surgically removed. In a laparoscopy, a small incision is created near the pubic bone to hide any scarring, and the appendix is removed using a laparoscope. Patients who undergo laparoscopic surgeries usually require less recovery time than patients who undergo open surgery.
A Colectomy refers to a surgical procedure performed to remove or resect the entire colon or a portion of it. Removing the entire colon is called a total colectomy. Removing only a portion, either the left or right portion, is called a hemicolectomy. An anterior resection refers to the removal of the sigmoid colon and the upper rectum. Most colectomies are performed as a treatment for colorectal cancer. Colectomies can be performed using the traditional open surgery method, or through a laparoscopy. In a laparoscopic procedure, the surgeon uses an instrument called a laparoscope to view the colon through a thin tube inserted through a tiny incision. Surgical instruments can also be inserted in two or more small incisions to perform the procedure.
A Colonoscopy is a diagnostic procedure performed to examine the inner lining of a patient’s colon. The procedure is normally required when the doctor suspects certain conditions such as the presence of colorectal cancer or polyps, to determine the cause of bloody stool or iron deficiency anemia, or to find out why a patient experienced sudden weight loss. During a colonoscopy, the doctor will insert a thin tube called a colonoscope up the patient’s anus and guide it to the colon. A colonoscope is fitted with a light source and a video camera so the doctor can examine the colon. The whole procedure takes around 30 minutes to complete. However, it can take a few days to prepare for the procedure.
A Colostomy is a surgical procedure that involves splicing the large intestine and colon and attaching one end to an opening in the abdominal wall. Stools that pass through the intestine are then directed to the opening instead of proceeding to the rectum and going out the anus. A Colostomy can either be temporary or permanent. Temporary Colostomies are performed when the lower bowels are having problems and need to be rested. Permanent Colostomies, on the other hand, are necessary for patients whose lower bowels are diseased and can no longer function. Patients who need to undergo a colostomy, whether permanent or temporary, will be informed on the best ways to live a normal life with their condition.
Patients at RSIM General and Colorectal Surgery are scheduled for an initial consultation to determine if they have an existing medical condition. During this meeting, their symptoms will be assessed and tests will be performed to identify the cause/s of the problem. After a diagnosis has been made, the patient will be presented with treatment options based on the severity of the condition. These options may include surgical procedures such as Stapled Hemorrhoidectomy, Oesophagogastroduodenoscopy, Hemorrhoidectomy, or Colorectal Surgery. If surgery is indeed to be performed, the patient will be informed about the risks and possible complications as well as the benefits of the procedure.
Excision Anal Wart (EUA)
Anal warts are small growths that appear around the anus (external) or inside the anal canal (internal). If left untreated, there is a chance that they'll become cancerous. Thus, doctors usually recommend that they be excised or burnt. In some cases, the surgeon may also remove a wart to test for cancer (biopsy). Anal wart excisions are performed while the patient is under general anesthesia. The surgeon will then use a scalpel or laser to remove the wart. Recovery from the procedure can take a couple of weeks, but the patient should be able to return to normal activities a week after the procedure.
Excision of Subcutaneous Tissue
Excision of subcutaneous tissue is a minor surgical procedure that can be performed as a treatment for skin conditions such as the presence of an abscess or for cosmetic purposes. The procedure starts by cleaning the area thoroughly and administering a local anesthetic. In cases wherein abscesses are present, the doctor will open the abscess to allow the pus to drain. When performed as a treatment for axillary osmidrosis, the procedure involves excising the apocrine and eccrine glands. The recovery time required will depend on the method used in the procedure, size of the area treated, and healing abilities of the patient.
A follow-up consultation with specialists at RSIM General and Colorectal Surgery is required following certain procedures or treatment. The goal is to make an accurate diagnosis based on the results of the diagnostic tests or gauge the success of a previous operation, as well as ensure that no complications have developed.
Gallbladder Removal / Cholecystectomy
A Cholecystectomy is a surgical procedure to remove the gallbladder. In an Open Cholecystectomy, the surgeon creates a 5 to 8-inch long incision from the ribs extending to the waist. In a Lap (Laparoscopic) cholecystectomy, the gallbladder is removed using a laparoscope, which is a thin tube with a camera and light source attached to the tip. Special surgical instruments can also be attached. To perform this procedure, the surgeon will first create a tiny incision just below the navel. Three more small incisions will be created above the abdomen where the surgical instruments are inserted. A Lap cholecystectomy requires less recovery time, so the patient will be able to return to normal activities sooner.
Partial Gastrectomy, also referred to as a Subtotal Gastrectomy, is a surgical procedure performed to remove the lower or upper portion of the stomach. The procedure is commonly performed as a treatment for stomach cancer but is also performed to treat patients with severe cases of stomach ulcers. The patient is first administered a general anesthetic. The surgeon will then create an incision in the abdomen and then remove the portion of the stomach with cancer or has been damaged due to an ulcer. The remaining portions are then reconnected using sutures, and the incision is closed. The whole procedure usually takes around 3 hours to complete.
A Hemorrhoidectomy is a surgical procedure performed to remove hemorrhoids. In some cases, the procedure will also involve surgical treatment for a fistula, a small cavity that usually contains pus. The outer opening of the fistula will usually heal over time, but the inner opening won’t, so pus will build up again, and the process is repeated. Surgical treatment for a fistula involves opening the entire fistula and allowing it to heal from the inside. Another treatment method is to inject fibrin glue to seal it.
Herniorrhaphy is a surgical procedure that is used to repair a direct or indirect hernia. In a direct hernia, the hernia is bulging out the abdominal wall; this can be treated by simply pushing the bulge back into place. In an indirect hernia, where the hernia is going down the inguinal canal, the surgeon can either push back the hernia sack and tie it off or remove it altogether. The surgeon will then repair the weak spot in the muscle wall by sewing the muscles together, or through other methods depending upon the location of the weak spot. Recovery from the procedure can take up to six weeks, and the patient is advised to refrain from any strenuous activities during this period.
Each patient at RSIM General and Colorectal Surgery receives a comprehensive medical report that is typically required before a treatment programme is initiated. This document contains the patient’s medical history, symptoms being experienced, the results of laboratory tests and other diagnostic procedures that were previously performed, and the specialist’s recommendation on the best treatment option.
OGD & Colonoscopy
An Oesophagogastroduodenoscopy (OGD) or simply referred to as a Gastroscopy is performed to examine the stomach, oesophagus, and duodenum. It can also sometimes be combined with another procedure called a Colonoscopy, an examination of the colon. A Gastroscopy and Colonoscopy are usually performed when the doctor needs to find the cause of a symptom of certain conditions such as anemia. Prior to the procedure, the patient will be given a light sedative and a local anesthetic. The doctor may also need to obtain test samples of the colon, stomach, oesophagus, or duodenum for a biopsy, or remove a polyp during the Colonoscopy.
Oesophagogastroduodenoscopy (OGD) is a type of examination of the upper digestive tract to determine the presence of disorders such as ulcers, gastritis, and cancer. The examination is a performed using an endoscope, a device with a light source and camera attached to the tip of a thin tube. The endoscope can also accommodate special instruments so the doctor can perform other treatment procedures at the same time. Prior to the procedure, the patient is given a mild sedative and a local anesthetic is applied to the back of the throat to prevent the patient from gagging. In most cases, an OGD will take approximately 10 minutes to complete. However, it can take a bit longer if the doctor also needs to perform treatments or take a sample for a biopsy.
Specialists at RSIM General and Colorectal Surgery provide a comprehensive specialist report that contains detailed information about the patient’s condition. This includes the symptoms being experienced, the results of the diagnostic tests that were previously performed, and the recommended treatment programmes to address the condition. This information is explained in detail during a follow-up consultation.
Hemorrhoids are clumps or masses of tissue within the anal canal. These contain blood vessels and supporting tissues that are made up of muscles and elastic fibers. Hemorrhoids are normal and everyone has them, but for some people, hemorrhoids grow and sometimes even cause problems. A Stapled Hemorrhoidectomy is a surgical procedure to treat abnormal hemorrhoids. However, instead of removing the hemorrhoid like in a traditional hemorrhoidectomy, the hemorrhoid is stapled back into place using a special stapler. The advantages of a stapled hemorrhoidectomy versus a traditional procedure are that the patient experiences less pain after the procedure and can return to normal activities sooner.