The minimally invasive and robotic surgery service aims to provide world-class gynaecological treatment, surgery and training for conditions such as dysfunctional uterine bleeding, uterine fibroids, endometriosis and ovarian cysts by providing conventional laparoscopic and robotic approaches for adnexal surgery, hysterectomy, myomectomy and endometriosis excision. We aim to provide a holistic approach to treatment using non-surgical approaches where appropriate but also to offer high quality state-of-the-art of surgery.

The benefits of robotic surgery over open and conventional laparoscopy are essentially due to enhanced 3D HD vision, greater precision and gready improved surgeon ergonomics. The resulting benefits include reduced hospital stay and faster return to normal activities, reduced blood loss and need for transfusions, reduced post-operative complications and a reduction in the need for conversion to open surgery.

Abnormal bleeding affects women of many ages from hormonally imbalanced cycles at either end of the age range through to problems caused by endometrial abnormalities, uterine fibroids and ovarian cysts. We aim to offer women a wide range of options including hormonal manipulation, resection of polyps, fibroids and

thickened endometrium and minimally invasive hysterectomy for appropriate cases.

Robotic hysterectomy offers an approach that in comparison to open and conventional laparoscopy is demonstrating less post-operative complications, shorter length of stay, reduced blood loss

and transfusions and reduced risk of conversion to open surgery.

We achieve most of our hysterectomies minimally invasively with very low complication rates and mainly 24-hour hospital stay making this now a true alternative to medical therapies if a

definitive treatment is required.

Pelvic pain affects many women and may be due to conditions such as endometriosis, irritable bowel syndrome, interstitial cystitis, neuropathic pain or psycho-sexual issues. It can cause significant morbidity particularly in terms of career, social life and relationships. Its management is a multidisciplinary problem requiring input from specialties such as gynaecology, urology, gastroenterology, psychology and pain clinics.

Endometriosis affects at least 8% of the population and may result in pain or subfertility. Medical and surgical treatments are employed on an individual case-by-case basis according to a woman's age, symptoms and desire for fertility.

Robotics offers us the ability to achieve greater accuracy in disease clearance and reduce the high risks of morbidity where surgery is required for complex cases.

Fibroids are common and often do not require treatment. They can cause multiple symptoms including menorrhagia, pain, bloating sensation, back pain, constipation and urinary frequency.

Where surgery is required, robotics makes myomectomy technically easier so that more complex cases can safely be performed minimally invasively.

The writer is a Senior Consultant at the Department of Obstetrics & Gynaecology of Singapore General Hospital.