General Surgery

Benign Breast Diseases

• Nipple discharge and nipple eczema
• Benign breast lumps
• Breast pain
• Cellulitis or abscess of the breast
• Breast reduction for symptomatic macromastia
• Correction of breast asymmetry
• Gynaecomastia

Breast Cancer

• Screen- detected / asymptomatic cancers
• Symptomatic cancers (lump, paget’s disease, nipple discharge, retraction or inversion, peau d’orange changes)
• Breast conservation surgery (Wide local excision) - palpable or wire-guided
• Mastectomy
• Axillary surgery (dual technique sentinel lymph node biopsy and axillary clearances)
• Primary endocrine therapy (PET) in medically unfit hormone positive cancers (PET)
• Male breast cancer

Breast Reconstruction

• Local or pedicle flaps
• Implant reconstruction
• Lipofilling of breast
• Nipple reconstruction
  

KTPH Colorectal team uses innovative techniques and collaborative care to make surgery safe and to shorten the length of stay. All the surgeons are trained in advanced laparoscopic (keyhole) surgery, and two-thirds of all elective operations for bowel cancer are completed laparoscopically.

A successful Geriatric Surgical Service (GSS ) for elderly patients since 2007 has resulted in improved surgical outcomes. The team has an established and effective enhanced recovery (ERAS) care program with a median length of stay of 5 days after major colorectal operations. The team has also introduced pelvic floor service for disorders like faecal incontinence, prolapse disorders and other functional bowel conditions.

Our close working relationship with medical and radiation oncologists from National Cancer Centre allows us to adopt a multidisciplinary approach for treatment of colorectal cancers. A bi-monthly multidisciplinary meeting discusses all cancer patients and also reviews outcome data. Our team is dedicated to provide evidence based and compassionate care to all our patients.

Treatment

• Diagnostic and therapeutic endoscopic procedures, including colonoscopy, the insertion of colonic stents and transrectal ultrasound scans
• Colonic, low anterior and abdomino-perineal resections, via both open and laparoscopic approaches
• Trans-anal resection of various ano-rectal pathologies, including Trans-anal Endoscopic Microsurgery (TEMS)
• Complex anal fistula repair
• Surgery for inflammatory bowel disease and its complications
• Surgery for Rectal Prolapse Disorders
• Assessment and Management of Functional Bowel Disorders like Faecal Incontinence, Chronic Constipation, Defecatory Disorders
• Multiple options for Hemorrhoidal Disorders
• Endoscopic Submucosal Dissection (ESD) of colonic lesions

Treatment

• Evaluation of neck lumps / nodes / cysts
• Investigation and management of suspected salivary glands tumours / swellings
• ONE-STOP “Quadruple Assessment” Thyroid Clinic provides a single day hassle-free, cheaper and faster evaluation of thyroid nodules (Goitre)
• Surgery for Benign and Malignant Thyroid Pathology
• Parathyroid Surgery (Primary & Secondary Hyperparathyroidism):
  Conventional & Minimally Invasive Parathyroid Surgery
• Adrenal Surgery (Laparoscopic, Retroperitoneal laparoscopic and Open conventional approach)

KTPH is the first hospital in Singapore to adopt this approach with the ESAT team commencing operations in 2014. The ESAT team admits all general surgery acute and trauma patients during the daytime from Monday to Friday at 7.30am - 4.00pm. This novel approach allows for a dedicated consultant level service provision for critically ill patients that are admitted through the emergency department.

Conditions

• Acute abdominal pain
• Acute appendicitis
• Biliary Colic/Acute cholecystitis/cholangitis/pancreatitis
• Colitis/Enteritis
• Bowel obstruction - malignant and benign
• Intra-abdominal sepsis
• Soft tissue infections
• Blunt and penetrating traumatic injury

Treatment

• Consultant led team dedicated to emergency surgical and trauma patients
• Rapid assessment of critically ill surgical patients in emergency department
• Timely surgery for emergency surgical and trauma patients
• Established collaboration with Interventional radiology and ICU for holistic care
• Acute and elective endoscopy
  

The KTPH Hepatobiliary and Pancreatic Surgery Service specialises in the management of conditions affecting the liver, pancreas, gallbladder, and biliary system.

In the management of benign conditions, we strive to provide timely and safe care to our patients. Day-surgery and short-stay surgery can be offered for selected conditions, such as the laparoscopic management of gallstone diseases. We also incorporate minimally invasive techniques in a large proportion of our surgical work.

We endeavour to provide compassionate and progressive care to our cancer patients, who may present with a complex range of conditions. All complex cases are reviewed at a weekly multidisciplinary meeting for consensus, review of updated evidence, and audit. Extended or multi-visceral resections may be necessary in selected patients with more advanced disease states.

We are supported by a tightly-knit team of professionals from diverse fields such as Anaesthesiology, Intensive Care, Hepatology, Advanced Endoscopy, Radiology, Medical Oncology, and Radiation Oncology. Placing the patient at the centre of our efforts, each cancer patient's journey is aided by a dedicated team of Physiotherapists and Dieticians as part of our Enhanced Recovery After Surgery (ERAS) programme. Minimally invasive techniques may be employed for suitable patients after close review of each case. In suitable patients with hepatocellular carcinoma, referral for liver transplant may be considered on a case-by-case basis.

Liver

• Benign liver conditions e.g. haemangioma, focal nodular hyperplasia (FNH), hepatic adenoma, liver cysts, recurrent pyogenic cholangitis (RPC), intrahepatic stones
• Malignant liver conditions e.g. hepatocellular carcinoma (HCC), cholangiocarcinoma or bile duct cancer
• Secondary liver cancers such as cancer of the colon, lung or breast that have spread to the liver
• Major and/or wedge liver resections (open or laparoscopic/keyhole surgery)
• Management of malignant liver tumours by radiological techniques e.g. imaging-guided microwave ablation, trans-arterial chemoembolisation
• Ultrasound-guided procedures including drainage of liver abscesses and liver cysts

Pancreas

• Pancreatitis or inflammation of the pancreas (from multiple causes)
• Benign pancreatic growths and cysts
• Malignant (cancerous) pancreas conditions including pancreatic adenocarcinoma and neuroendocrine tumours of the pancreas
• Pancreaticoduodenectomy/ Whipple's procedure, to remove tumours of the head of the pancreas
• Distal pancreatectomy, to remove tumours of the body or tail of the pancreas

Gallbladder

• Gallstone and gallstone-related problems including inflammation and/or infection of the gallbladder (cholecystitis), biliary colic or symptomatic cholelithiasis, blockage of the common bile duct or pancreatic duct, and erosion of the gallstone into the nearby duct or structures (Mirizzi's Syndrome)
• Malignant (cancerous) gallbladder tumors like gallbladder cancer
• Gallbladder polyps
• Laparoscopic/keyhole or open cholecystectomy (surgical removal of the gallbladder)
• Ultrasound-guided procedures including drainage of gallbladder abscesses for patients unfit for surgery

Biliary Tract (Bile Duct)

• Choledochal cyst or biliary tract cysts
• Complicated bile duct stone disease (both inside and outside of the liver)
• Malignant (cancerous) biliary tract problems such as cholangiocarcinoma or bile duct cancers
• Resection/excision of the biliary tract (including choledochal or biliary cyst)
• Common bile duct exploration for complicated stone disease (including stone removal using various methods)
• Biliary reconstruction with Roux-en-Y hepaticojejunostomy or biliary bypass

Conditions

• Degenerative disc disease, prolapsed discs
• Cervical myelopathy
• Spinal stenosis
• Spine tumours, both intra and extra axial
• Acute fractures/dislocations/unstable spine
• Fusion and instrumentation for all levels both open and minimally invasive surgery
• Spinal corrective surgery, degenerative scoliosis, spondylolisthesis

Treatment

• Diagnosis and management of acute neurosurgical emergencies such as intracranial haemorrhages, acute traumatic head injury (bleeds, traumatic contusions, subdural and extradural haemorrhages)
• Tumour surgery, both for primary brain tumour, or secondary metastasis, including latest in endoscopic surgeries, navigation
• Congenital malformations, such as Chiari malformation
• Emergency vascular surgeries for aneurysm, AVM, cavernomas
• Treatment for hyperhidrosis (sweaty palms)
• CSF dysfunctional issues, hydrocephalus, shunts, external ventricular drains, CSF leaks
• Spine surgeries inclusive of occipital-cervical, cervical, thoracic, lumbar and lumbosacral, both open and minimally invasive surgery (keyhole surgery)

The KTPH Bariatric & Upper Gastrointestinal Surgery team consists of accredited Surgeons with Subspecialty interests in Upper Gastrointestinal Surgery, Bariatric & Metabolic Surgery, Minimally- Invasive Surgery and Advanced Therapeutic Endoscopy.

We evaluate and manage patients with:

• Obesity & Metabolic Syndrome
• Upper gastrointestinal tract precancerous and cancerous conditions
• Gastrointestinal Stromal Tumours (GIST) 
• Gastroesophageal reflux disease/Barrett's oesophagus
• Dysphagia / feeding issues / Dyspepsia
• Achalasia
• Gallstones disease
  
• Hernias
• Lumps and bumps

Bariatric & Metabolic Surgery & Treatment

• Laparoscopic Sleeve Gastrectomy
• Laparoscopic Roux-En-Y Gastric Bypass
• Endoscopic Bioenteric Intragastric Balloon (BIB) Insertion

Upper Gastrointestinal Surgery

• Oncological Surgery for Gastric Cancer/ Gastroesophageal Junction Cancer/ Esophageal Cancer via both laparoscopic and open approaches
• Surgery for Gastroesophageal Reflux Disease (GERD) and Achalasia

General Surgery

• Laparoscopic Cholecystectomy
• Hernia repair via both laparoscopic and open approaches
• Excision of Lumps & Bumps under Local and General Anaesthesia

Diagnostic & Advanced Therapeutic Endoscopy

• Esophagogastroduodenoscopy and Colonoscopy
• Endoscopic Mucosal Resection (EMR) & Endoscopic Submucosal Resection (EMR) of early neoplasia of Esophagus, Gastric and Duodenal Polyps 
• Endoscopic dilatation and stent placements for benign and malignant strictures of the Upper Gastrointestinal and Biliary tract
• Percutaneous Endoscopic Gastrostomy (PEG) and endoscopic enteric feeding tube insertion 
  
• Endoscopic management for Bile Duct Stone Disease (Endoscopic Retrograde Cholangiopancreatography (ERCP))

One-stop access to holistic multidisciplinary care (Endocrinologists, Weight Management Physicians, Dietician, Psychologists) is provided for patients with obesity and metabolic disease at the Integrated Care for Obesity & Diabetes (ICOD) clinic for evaluation and preparation for bariatric and metabolic surgery and further post-op weight loss maintenance.

The team works closely with many multidisciplinary teams to ensure holistic care is provided to all patients. This includes but not limited to the Geriatric Surgical Services (GSS), Nutritional Support Team (NST) and Gastrointestinal Tumour Board (GITB).

We collaborate closely with medical and radiation oncologists (from the National Healthcare Groups, National Cancer Centre and National University Cancer Institute), in-house Nutritional Support Team, Physiotherapists for multidisciplinary management of Upper Gastrointestinal cancer treatment.

The KTPH Plastic, Reconstructive and Aesthetic Surgery Service epitomizes the concept of trans-disciplinary patient care. We provide a wide-range of services, often times in close collaboration with various specialties within Yishun Health. In turn, this has transformed and enabled our surgeons to handle more challenging and complex cases, knowing that reconstruction would be an available option. The cornerstone of our service is adding quality years of life to our patients, by improving functional, physical as well as psychosocial well-being.

In addition, we strongly believe in contributing back to the field of medicine by actively engaging in education and research. The KTPH Plastic, Reconstructive and Aesthetic Surgery Service is also recognised as an accredited training site of the nation-wide Integrated Plastic Surgery Residency Programme.

Reconstructive procedures

• Breast Reconstruction
• Chest Wall Reconstruction
• Abdominal Wall Reconstruction
• Lower Extremity Reconstruction
• Reconstruction after Cancer Surgery
• Management and Reconstruction of Complex Wounds
• Skin Cancer Surgery and Reconstruction
• External Ear Reconstruction
• Craniofacial Reconstruction After Trauma
• Facial Fracture Surgery
• Head and Neck Reconstruction
• Facial Reanimation Surgery

Breast procedures

• Breast Reduction
• Breast Lift (Mastopexy)
  
• Gynaecomastia Surgery
• Breast Augmentation

Cosmetic procedures

• Blepharoplasty
• Ptosis Correction
• Brow lift
• Rhytidectomy
• Neck lift
• Body Contouring Procedures
• Liposuction
• Abdominoplasty
• Facial Rejuvenation
• Rhinoplasty
  

Others

• Scar Management and Surgery
• Minor Burns Management and Surgery
• Excision of Benign and Malignant Lesions of the Face
• Laser Services

The KTPH Vascular Surgery team is skilled in both open and endovascular treatments for a range of vascular conditions. Our specialists work in tandem with other specialist teams, allied health and nursing colleagues to deliver comprehensive yet tailored management of our patients. 

The diabetic foot service, a multidisciplinary effort, is led jointly by the Vascular Surgeons and the Orthopaedic Surgeons. 

The team is also heavily committed in educating juniors and findings ways to constantly improve patient outcomes.

Services offered by our team include:

• Lower extremity revascularisation for peripheral arterial disease causing claudication, pain or ulceration via open or endovascular treatment
• Thoracic and abdominal aortic, visceral and peripheral aneurysms repair, including endovascular repair of thoracoabdominal aneuryms and aortic dissections
• Carotid endarterectomy and stenting for stroke prevention
• Vascular access for haemodialysis encompassing creation and endovascular maintenance of the access
• Vascular control and reconstruction for trauma and injury
• Medically-indicated treatments for varicose veins inclusive of open and endovenous therapies
• Surgery and endovascular thrombolysis for severe acute deep venous thrombosis
• Management of diabetic foot and venous ulceration
• Amputations for non-salvageable limbs