|Telephone:||(852) 2255 4763|
|Fax:||(852) 2872 8425|
Activities and Services
The Division of Colorectal Surgery is responsible for the management of patients with benign and malignant diseases of the colon, rectum, anus, small intestine and appendix. With the expertise in general surgery and advanced laparoscopic skills, the Division also takes care of patients with abdominal wall hernias, both on the elective and emergency settings.
Strengths and Developments
A multidisciplinary approach with the emphasis on minimally invasive surgery is adopted by the Division in the management of colorectal cancer. Biweekly Multidisciplinary Treatment meeting with clinical oncologists, medical oncologists, radiologists, stoma nurses, and colorectal nurses is held to discuss individual patients in order to offer the best treatment.
Being a tertiary referral centre, the Division manages a high percentage of patients with rectal cancer. The specialists of the Division are capable of different approaches in the management of rectal cancer, with the objectives of sphincter preservation and a low recurrence rate. Total mesorectal resection for mid- and low-rectal cancer has been adopted as the standard surgical technique in the treatment of mid and distal rectal cancer since 1993. Currently, laparoscopic total mesorectal excision is regularly performed with equivalent oncologic outcome in patients with rectal cancer. The sphincter- saving rate is maintained at 90% for all mid and distal rectal cancers. The local recurrence rate for patients with low anterior resection has been maintained at around 7%.
Multi-disciplinary treatment meeting for colorectal malignancy
Being a tertiary referral centre, the Division manages a high percentage of patients with rectal cancer. The specialists of the Division are capable of different approaches in the management of rectal cancer, with the objectives of sphincter preservation and a low recurrence rate. Total mesorectal resection for mid- and low-rectal cancer has been adopted as the standard surgical technique in the treatment of mid and distal rectal cancer since October 1993. Currently, laparoscopic total mesorectal excision is regularly performed with equivalent oncologic outcome in patients with rectal cancer. The sphincter- saving rate is maintained at 90% for all mid and distal rectal cancers. The local recurrence rate for patients with low anterior resection has been maintained at around 7%.
Being a tertiary referral centre, the Division also manages patients with advanced or recurrent colorectal cancers. A multi-disciplinary approach is adopted to design treatment plan for individual patients. Preoperative chemoradiotherapy as well as postoperative chemotherapy and radiotherapy are employed as adjuvant therapy in addition to surgery if necessary. Ultra-major resections such as abdominosacral resection, peritonectomy and exenterative surgery are performed regularly with a low mortality and morbidity.
Cytoreduction surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) for a patient with pseudomyxoma peritonei
A protocol for enhanced recovery after surgery (ERAS) has been developed for our patients with elective colorectal resection. The aim is to standardize the treatments for postoperative patients so that a more efficient and systematic patient care can be provided and hopefully the length of hospital stay can be shortened. This, together with the minimally invasive approach, has improved the postoperative outcome and shortened the hospital stay.
Inflammatory Bowel Disease
The incidence of inflammatory bowel disease (IBD) is much lower in Hong Kong compared with Western countries. The Division works closely with gastroenterologists in the management of these patients. A joint clinic with the gastroenterologist is being held weekly to see patients with IBD. Complex procedures for Crohn’s disease and ulcerative colitis are regularly performed. With the skills in minimally invasive surgery, most of these procedures are performed with laparoscopy.
Ligation of Intersphincteric Fistula Tract (LIFT) procedure
Minimally invasive colorectal surgery
With the availability of advanced laparoscopic skills of most members of the Division, the development in minimally invasive colorectal surgery is the main direction of the Division. Besides the regular performance of complicated colorectal procedures, we are now exploring the techniques of incisionless surgery and natural orifice surgery. Since starting robotic-assisted colorectal surgery with the Da Vinci Robotic Surgical System in 2008, we are one of the few centres in Hong Kong which regularly performs robotic-assisted rectal resection. Different surgical approaches, like transanal mesorectal resection (TaTME), with the objectives to offer the best care to the patients are adopted.
Da Vinci Robotic Surgical System
Transanal Total Mesorectal Excision (TaTME)
Endoscopy and Stenting
The Division performs over 1,500 colonoscopies and 2,000 sigmoidoscopies each year. In addition to the diagnostic procedures, therapeutic procedures such as colonoscopic polypectomies and insertion of metallic stents are regularly performed. Advanced endoscopic techniques, such as endoscopic mucosal resection (EMR) and endoscopic submucoal dissection (ESD), are continuously acquired by members of the Division.
Anorectal physiology laboratory
The anorectal physiology laboratory was established in 1995 with the aim to provide objective investigations (such as colonic transit study, 3D endorectal/endoanal ultrasound and high resolution anorectal manometry) for patients with functional bowel disorders. Endorectal ultrasound helps in the accurate staging of patients with rectal tumour, and endoanal ultrasound could help in managing the complicated anal fistulas or sphincter injury. These then allow the most appropriate treatment to be offered. Anorectal manometry could assess the sphincter function after rectal resection and bowel training can be considered accordingly.
Hernia surgery has evolved rapidly in recently years and is field of continuous development and research. The Division, together with the staff of TWH, manages patients with abdominal wall hernias. A clinic catering for new cases of abdominal wall hernias was set up in 2007 in Queen Mary Hospital. Emphasis is put on the laparoscopic repair and continuous research in the types of prosthetic mesh and the technique of extraperitoneal repair of groin hernia is underway. Moreover, incisional hernias are now mostly repaired with the laparoscopic approach to reduce the surgical trauma.
Needleoscopic Total Extra-Peritoneal (TEP) Hernioplasty with 3mm instruments
Use of Intra-Peritoneal On-Lay Mesh (IPOM) for Incisional Hernia Repair
|Colorectal Clinic, S4, QMH||
|Comprehensive Joint Colorectal Cancer Clinic
(With Department of Clinical Oncology)
|Inflammatory Bowel Disease Clinic
(With Division of Gastroenterology Department of Medicine)
|Bowel Continence Clinic||Thursday (a.m.) (every 1st/3rd week)|
|Hernia Clinic, S4, QMH||Wednesday (a.m.)|
|Hernia Clinic, TWH||Friday (p.m.)|
|Direct Access PR Bleeding Clinic, TWH||Monday (a.m.)|
|Colorectal Clinic for Private Patients
Tel: (852) 2255 4293
|J1 Clinic (Dr. S.H. Lo)|
|Operating day||Monday: TWH
Friday: QMH (Alternative week)
|Endoscopy sessions||Monday (p.m.)
|Dr. Oswens Siu-Hung LO
|Division member||Consultant||Hospital Authority staff||(852) 2255 email@example.com|
|Dr. Joe King-Man FAN
|Division member||Consultant||HKU-SZ Hospital staff||(852) 2255 firstname.lastname@example.org|
|Dr. Chi-Chung FOO
|Division member||Clinical Assistant Professor||Academic staff||(852) 2255 email@example.com|
|Dr. Hok-Kwok CHOI
|Division member||Associate Consultant / Honorary Clinical Assistant Professor||Hospital Authority staff||---||---|
|Dr. Rockson WEI
|Division member||Associate Consultant / Honorary Clinical Assistant Professor||Hospital Authority staff||(852) 2255 firstname.lastname@example.org|
|Dr. Julian TSANG
|Division member||Associate Consultant||Hospital Authority staff||---||---|
|Dr. Diane Toi-Yin CHAN
|Division member||Resident Specialist||Hospital Authority staff||---||---|
|Dr. Felix Che-Lok CHOW
|Division member||Resident Specialist||Hospital Authority staff||---||---|