The life of a surgeon is not always a bed of roses. Colorectal Surgeon Dr Chong Choon Seng strives to deliver the greatest outcome every time he enters the operating theatre. With more than two decades under his belt, Dr Chong shares his life experiences in the medical field.
Providing the best possible care for patients
Dr Chong Choon Seng, a colorectal surgeon at Mount Elizabeth Hospital in Singapore, enjoys watching medical Korean dramas when he is not in the operating theatre. Something he enjoys doing in his spare time, he said the scenes from the dramas are not always as intense in real life.
“The steps and details are correct in these dramas, but there is a lot of dramatisation because that is what the audience wants to watch. In real life, blood does not always splatter on our faces,” said the surgeon with over 20 years of experience.
However, the intensity depicted in each surgery scene is somewhat relatable, he added.
“The feelings and tension are nicely conveyed. As a surgeon, I recognised them because they reminded me of my own personal operating room experiences.”
Dr Chong, who had always wanted to be a surgeon in the medical field, described his first time in the operating theatre as both daunting and exciting. A common feeling amongst new surgeons, he said his first few years as a surgeon kept him awake a lot due to overthinking.
“Back then, I encountered a number of cases that could be challenging. Such major cases involve cancer, and I usually think about the plans a lot. It causes me to lose sleep at times. Say I have a big case tomorrow, and I will be the main surgeon with a senior surgeon beside me.
“I usually think about what steps to take first and what comes next. Then I will go through it 10 more times to make sure I am doing everything correctly.”
Nonetheless, with years of experience in the medical field, Dr Chong learned that good planning along with alternative plans can help him in the operating theatre.
“Over time, surgeries got more predictable. But it does not mean it gets any easier. As a surgeon, I must recognise when things will become difficult or when I will encounter difficulties. When this happens, I usually slow down the surgery and rethink,” he said.
Dr Chong would usually take a restroom break in between major cases, which might take up to 12 hours, while his assistant continued with minor parts of the surgery. He would return to the surgery after taking a good 15 minutes’ worth of rest.
According to him, some cases can take a long time — perhaps up to 24 hours. However, it is unlikely that one surgeon will complete the entire procedure. Sharing further, he said that if there is cancer in the rectum that also invades the vaginal or urine system, a senior urologist or a gynaecologist would be there to take turns doing the surgery.
In addition to the different types of specialist surgeons present in the operating theatre, Dr Chong said that there would normally be an anaesthesiologist and team, a senior surgeon with a junior surgeon assistant, a scrub nurse, and a circulating nurse. He added that if a robot is required during surgery, a medical robotics team will be present as well.
“Depending on the circumstances of the procedure, every person in the operating theatre is there for a reason. It is to ensure that if something goes wrong, there is someone in the room who knows what to do.”
Today, the colorectal surgeon emphasises that with good planning, a surgery can be completed successfully.
“… and with that, I am not losing as much sleep as I was 20 years ago. When a case goes wrong, we simply switch to plan B. It may take longer than usual, but it does not matter because the patient’s safety is important.”
Before commencing an operation, he said that he usually sets a time limit for how long a procedure can last. This is an essential process for him as he does not want to spend too much time performing the operation.
“For technically challenging surgeries, setting a time is often necessary for safety purposes. I would set down a time for myself to keep track of; if I exceed, I would think that I would compromise the patient’s condition. I would think that maybe I should not persist, or whether I should do it the conventional way.
“So having time to track puts us in check because if we work for a lengthy period of time, like 13 hours, we have to ask ourselves if that is the right thing to do.”
Aside from that, the medical director spends time speaking with his patients prior to surgery. As a doctor, he believes that the key to a successful surgery is a personal touch. Being in a humanistic field and having to meet people every day, he believes patients should not come to the hospital feeling sad.
“Instead, I want my patients to feel at ease and assured that the person who will be operating on them truly cares about them. I attribute part of my success to patients who are positive about the procedure. It somehow makes them feel better afterwards. This is not to say that there aren’t complications. It simply implies that my patients have faith in me to get them out of problems.”
A senior consultant and colorectal surgeon, his special expertise includes colonoscopy and gastroscopy; colonic stenting for malignant colon obstruction; surgery for colorectal cancers, diverticular disease and inflammatory bowel disease; robotic surgery and transanal total mesorectal excision for low rectal cancer; minimally invasive or laparoscopic colorectal surgery; management of constipation and incontinence; complex and recurrent anal fistula treatment; and stapler and laser piles surgery.
To date, Dr Chong has performed more than 1,500 major surgeries and numerous complex colorectal cancer operations. He also holds an academic title as an Assistant Dean (Enterprise) in NUS Medicine and is an active volunteer for community outreach programmes.
