New success in laparoscopic liver resection surgery

Friday, 2017-08-11 09:21:21
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Doctors at the HCM City University Medical Centre perform a laparoscopic liver surgery.
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NDO – A research team from the University Medical Centre (UMC) Ho Chi Minh City has won an award for the best laparoscopic liver surgery video at the 1st World Congress of the International Laparoscopic Liver Society, held in Paris, France, last month.

This success has created a new landmark for the Vietnamese health sector in the field of laparoscopic liver surgery, acting as a driving force for the hospital to continue to develop new techniques to improve the chances of success for patients.

In Vietnam, liver cancer is a type of malignant diseases that is quite common among the population. The main causes of this disease are hepatitis, cirrhosis and several other diseases. The disease progresses quietly and is difficult to detect in its initial stages, therefore when patients arrive at a medical facility, the disease is usually in its later stages, leading to poor prognosis and difficult treatment.

The UMC is currently one of the country’s leading centres for screening, diagnosis and treatment of liver cancer. With multi-paradigm treatment, the hospital receives around 1,000 new liver cancer patients each year, with approximately 20% of patients being treated by surgery, 20% receiving radi frequency ablation (RFA) treatment and 40% receiving transarterial chemoembolisation (TACE) treatment.

For the purpose of safe, radical and gentle treatment, the UMC’s liver cancer treatment unit has made breakthroughs in the treatment of the disease using modern methods, such as calculating the left liver volume, hepatic portal vein thrombosis technique and indocyanine green (ICG) screening technique.

Liver resection surgery is a radical treatment that is commonly used for patients with liver cancer, however, most cancers of the liver occur in people with chronic hepatitis and cirrhosis, so surgical treatment must always be carefully considered and evaluated.

Measurement of the remaining liver volume and hepatic functional reserve is always considered as a major challenge for professionals. At the UMC, doctors have actively implemented the techniques to assess liver function and calculate the liver volume retained in patients.

According to Dr. Tran Cong Duy Long, deputy head of the hospital’s hepato-biliary and pancreatic surgery department, removing a tumor-bearing part of the liver is one of the most radical and best therapies for liver cancer patients. However, UMC’s experts have to calculate and determine how much of the liver’s remaining volume is enough to remove the cancer cells, while ensuring the safety and quality of life for patients post-surgery.

In some cases in which safety is not ensured to remove a liver’s part bearing tumors, or the liver is not sufficiently large enough, then the portal vein thrombosis technique is considered the optimal solution for the liver to proliferate eligibly for surgery, thus improving the effectiveness of cancer treatment.

Dr. Long stated that 25-30% of patients with liver resection are performed by laparoscopic surgeries. Instead of a long incision under the ribs, patients suffer only minor incisions from 4-10 mm, with a hospital stay of four to six days.

To date, over 300 laparoscopic liver resection surgeries have been performed at UMC since 2005. The results have been published in many international magazines and reports at conferences in and outside the country, and have brought about a range of popular science awards for the hospital.

The latest highlight is the award for the best laparoscopic liver surgery video at the first World Congress of the International Laparoscopic Liver Society, held in France in early July. The event gathered most of the world's leading experts in laparoscopic surgery, presenting updates on indications, techniques and organisation of laparoscopic liver resection. Nearly 300 abstracts and videos were submitted to the congress, which then selected 37 papers and 17 videos to be presented with awards.

Assoc. Prof, Dr. Nguyen Hoang Bac, director of the hospital, said that the success of the UMC research team has raised Vietnam’s position in the field of laparoscopic liver resection surgery. In the near future, the hospital will continue to bring into full play its strengths, develop new technologies and create more opportunities for patients.

In addition to the above-mentioned methods, the UMC’s endoscopic surgery unit has been developing an ICG screening technique for liver cancer treatment. This is one of the most accurate liver function assessment techniques, which is being deployed for the first time in Vietnam.

The ICG technique allows doctors to determine exactly which patient should be operated on and to what extent the tumor should be cut to maximise treatment efficiency, helping to increase the safety for liver cancer patients undergoing surgeries.