Miracles in Vietnam microsurgeries

Thursday, 2020-05-21 15:50:57
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Vietnamese doctors have successfully performed the world’s first hand transplant with the donor hand coming from a living donor.
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NDO – At the age of 28, Nguyen Manh Hung burst into tears standing on his healthy feet after years suffering from his legs bent like tree roots. A year later, Pham Van Vuong could not think that his left hand crushed by a rolling mill four years ago could be ‘reborn’ thanks to a hand transplant from a living donor. The wonderful microsurgery and talent of Vietnamese doctors has given the duo new lives.

>>> Vietnam carries out world’s first limb transplant from living donor

>>> One more “miracle” in Vietnam’s microsurgery sector

‘Reborn’ thanks to microsurgery

Pointing to his straight legs, Nguyen Manh Hung, 30, from the northern province of Nam Dinh, happily said that over the past two years, he has seen his normal life return with the legs he has always wished for. Love also has come to him after years of difficulty. “It was like a dream, ever since I was born,” Hung said.

Right from his birth, Hung had an unusual pair of legs. When he grew up, his legs bent even more, making them look like roots. Hung also had the opportunity to be examined and consulted by American orthopaedic surgeons, but they shook their heads and said he was “incurable." Hung thought this was it and accepted a quiet life, earning his living by doing electrical repairs at home.

But life suddenly brought him a huge turning point after an accident caused complicated broken legs in April 2018, forcing him to be transferred to the Hanoi-based 108 Military Central Hospital.

Prof., Dr. Nguyen The Hoang, Deputy Director of the 108 Military Central Hospital, shares that upon seeing Hung's feet, specialised doctors were taken aback by such a strange and complicated deformity they had never come across in more than 30 years of their careers.

Hung’s legs were bent like roots.

One strange aspect here was that Hung’s legs were different in the length of their bilateral bones, while the entire bone and joint system in the thighs, shanks and feet were deformed and distorted in many different directions. He also suffered from severe bone thinning. The challenge was that if his legs were left untreated, Hung would have to have both limbs removed.

However, doctors still decided to try and build a new life for the ‘frog prince’ with a meticulous plan featuring precise intervention methods. After eight months of treatment and undergoing three surgeries, his legs were finally completely equal. Two years later, Hung now has his new life on his own firm feet and now is ready for happiness.

‘Frog prince’ Nguyen Manh Hung now has a new life.

After that miracle, doctors at the 108 Military Central Hospital this year also accomplished a new feat which is now resonating around the globe, making history in the world of limb transplantation and microsurgery, as they successfully performed the world’s first hand transplant where the donor hand came from a living donor.

The recipient is Pham Van Vuong, 31, from Hanoi’s Thanh Tri District. Four years ago, Vuong suffered an accident using a punching machine that left one third of his lower left forearm and the whole of his left hand damaged and deformed, forcing him to have almost a third of it under his left forearm amputated.

The transplant was from an unfortunate person who had an occupational accident and had to have his left arm amputated, the third below the patient’s forearm being relatively normal. Although facing multiple challenges due to a high risk of infection from the severely damaged limb, the hospital’s director, Prof., Dr. Mai Hong Bang, and the entire Board of Directors and surgical team decided in a special pre-surgery consultation to perform a ‘new hand transplant’ for Vuong.

After eight hours, the ‘new forearm and hand’ transplant from a living donor for Vuong was successful. All anatomical structures have recovered and the grafted hand has fully merged like a normal hand. Immediately after the operation, Vuong was able to move his ‘new’ fingers on his own.

Replanting limbs by applying microsurgery is an extremely difficult and complex technique, as well as involving tenuous plastic surgery and nerve vascular microsurgery. So far, although there have been tens of thousands of successful cases of replanting disjointed limbs in the world, limb transplant is much more difficult and challenging, as the complicated technique requires both donors and recipients be compatible with the donor’s blood group and immune system, and following surgery the recipients have to use suitable anti-rejection drugs in a much more serious and cautious manner than in many other tissue and organ transplants.

Imprint of ‘made in Vietnam’ microsurgery

Pham Van Vuong’s hand has been regenerated thanks to the noble humanitarian intentions of a donor.

The success of the limb transplant from the living donor marks a turning point in the Vietnamese medical sector on the world map of limb transplant and microsurgery. This is the first limb transplant in Southeast Asia, and it is also the first in the world with the donated limb having been taken from a living donor.

Prof., Dr. Mai Hong Bang proudly said that this success opens up new therapeutic directions in the future – not only grafting limbs from brain-dead donors but also from living ones to bring about new hope for unfortunate patients who have lost their limbs. This also marks a new development for Vietnam's microsurgery which has come a long way since US plastic surgeons, led by Dr. Craig Merrell, volunteered to come to Vietnam and began a program that offered treatment for patients who require microsurgical intervention. Dr. Craig and his colleagues introduced the industry's high-end technology to leading Vietnamese experts. From 1991 up until now, doctors at the 108 Military Central Hospital have successfully performed microsurgeries for thousands of complicated cases, with a success rate of over 95%.

Along with the intensive developments, in 2005 the hospital’s upper limb and micro-surgery department was established under the leadership of Prof., Dr. Nguyen Viet Tien (former Deputy Director of the 108 Military Central Hospital) and Prof., Dr. Nguyen The Hoang, who were well-trained in microsurgery in Germany.

Prof., Dr. Hoang said that microsurgery is always a difficult technique to perform, requiring ingenuity, meticulousness and precision from doctors, and its success rate has never been guaranteed to be 100%. Currently, Vietnam is one of the few countries that can successfully carry out hundreds of complicated microsurgeries with a recovery rate of over 97%.

At a recent microsurgical seminar in Hanoi, Prof. Seng-Feng Jeng from Operation Smile affirmed that he and his colleagues have travelled to many places around the world and collaborated with Operation Smile to share experiences and support different countries in their microsurgical techniques, but Vietnam is the leader in terms of developing this technique in the fastest and most effective way. Hailing the Vietnamese doctors’ work as a “miracle” in microsurgery, Seng-Feng Jeng affirmed that the Vietnamese technique is on a par with that in developed countries.

By Dang Luan