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About Assoc. Prof. Dr Fam Xeng Inn
范恒银医生,副教授
Consultant Urologist in UKM Specialist Centre,
Kuala Lumpur Malaysia
Dr Fam is an Associate Professor of Urology, he specializes in Advanced Laparoscopic and Robotic Surgery. He is also expert in performing all kinds of endourological surgery.
His expertise is in treatment of kidney, bladder, prostate, testis and adrenal cancer, kidney, ureteral stone, benign prostate enlargement and other urological dieases. He has vast experiences in management of complicated urological tumours, stones diseases benign prostate enlargement and penile parafinoma.
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Minimal Invasive Surgery
Minimal invasive surgery (MIS) is a type of operation performed through a few small incisions (about 5 to 20mm in length) or without skin incision. MIS include endourology surgery, laparoscopic surgery and robotic surgery. MIS provides patients several advantages with its small incisions.
Advantages
- Minimal postoperative pain
- Early postoperative mobilization
- Faster recovery
- Save cost (less days of hospital stay and less pain killer usage)
Long Term Advantages
- Better cosmetic (small scar )
- Minimal risk of adhesion colic ( bowel stick together or stick to abdominal wall)
- The risk of adhesion colic is highly related to the length of operation incision
Currently, almost all common urology surgeries can be performed through endourology surgery, laparoscopic surgery or robotic surgery. Common urology surgeries include:
- Transurethral resection of prostate (TURP): resection internal growth prostatic tissue due to benign prostatic hyperplasia. (BPH).
- Transurethal resection of bladder tumour (TURBT): resection of bladder tumour within the bladder cavity.
- Ureteroscopy lithotripsy (URSL): fragmentation and removal of ureteral stone.
- Retrograde intrarenal surgery (RIRS): fragmentation and removal of stone in kidney though urinary tract.
- Percutaneous nephrolithotomy (PCNL): fragmentation and removal of big and complicated kidney stone though a small incision at the kidney.
- Radical nephrectomy: removal of the entire kidney due to kidney tumour.
- Partial nephrectomy: removal of small kidney tumour and preserve the rest of kidney with normal tissues.
- Radical prostatectomy: removal of prostate due to prostate cancer.
- Radical cystectomy: removal of bladder due to advance bladder cancer.
- Pyeloplasty: reconstruction of upper ureter due to the narrowing of upper ureter.
- Ureter reimplantation: reconstruction of lower ureter due to the narrowing of lower ureter.

Endourology Surgery
Endourology surgery is performed by inserting an endoscope (cylinder shape camera with small diameter) into the lumen of urinary tract. Endoscope provides image and allow surgery to be performed within the lumen of urinary tract, by inserting laser, or resecting instrument. Diseases that can be treated with endourology surgery include benign prostatic hyperplasia (BPH), small bladder tumour, ureteral stone and renal stone. All of the endourology surgery does not require skin incision except percutaneous nehprolithotomy which require a 2cm incision.

Laparoscopic Surgery
Laparacopic surgery is performed by inserting a laparoscope (cylinder shape camera) and long surgical instruments into the body through small incisions or holes made at the body. The surgery is being performed under the vision of the laparoscope. Laparoscopic surgery is very skill demanding especially for complex surgeries such as radical prostatectomy, partial nephrectomy and radical cystectomy.

Robotic Surgery
A machine consists of four operative arms is used to perform the operation. The robotic arms with diameter about 1cm are inserted into body through small incision. Surgeon performs the operation by controlling the robotic arms at the console. The robotic arms will follow all the movement of the surgeon’s hand and fingers. Robotic surgery is precise and good for complicated surgery that involves reconstruction. However robotic surgery involves expensive surgery cost.
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