“In Thailand, if a patient has to undergo open surgery, they will ask the doctor to guarantee that laparoscopic surgery cannot be performed for their condition. If they later discover elsewhere that this method is available, they will sue the doctor for negligence,” shared Professor Nguyen Hoang Bac from the Ho Chi Minh City University of Medicine and Pharmacy.
“This indicates that laparoscopic surgery has become very popular and is the number one choice for both surgeons and patients today,” Professor Hoang Bac assessed.
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| A laparoscopic surgery at Binh Dan Hospital, Ho Chi Minh City (Photo: VNE) |
Previously, open surgery could cause colorectal cancer patients to experience uncontrollable bleeding from the sacrum, sudden ruptures of abdominal aortic aneurysms, or hypertension complications following adrenal gland removal… When these symptoms occurred, doctors could only watch as patients died on the operating table without any means of saving them, Professor Hoang Bac lamented. However, with the application of laparoscopic surgery, these medical conditions can be addressed very safely and effectively. In fact, there have been cases where patients did not lose a single drop of blood during surgery.
In the past, doctors were always afraid of making incorrect diagnoses when faced with patients showing symptoms of appendicitis. “And the situation of misdiagnosing symptoms and stages in this condition is quite common,” noted Professor Hoang Bac. But with laparoscopy, doctors can always accurately diagnose symptoms and stages of the disease. This allows timely surgical decisions, helping patients avoid many complications. Furthermore, this method effectively manages cases of ruptured appendicitis, and endoscopic diagnosis aids in detecting other pathologies beyond the appendix. Particularly for obese patients, doctors need to navigate 10 cm to locate the nerve. “With open surgery, overcoming a thick layer of fat to reach the required operational site is indeed a significant challenge. However, with laparoscopic instruments, this task becomes simple and, moreover, provides a sense of safety for both the doctor and the patient,” Professor Hoang Bac stated.
According to him, laparoscopic surgery has become the “Gold Standard“, the optimal method for treating gallbladder stones (a very common condition in Vietnam). Patients only require three very small incisions in the abdominal wall (almost leaving no scars) for stone removal. This technique effectively controls the likelihood of remaining stones after treatment, and patients can go home after two days. There is a success rate of 98% based on actual treatment outcomes. However, in open surgery cases, 100% of patients experience residual stones post-treatment.
Laparoscopic surgery has also become the “Gold Standard” for splenectomy in cases of thrombocytopenia. This method ensures patients do not need to return for medication after treatment, with a success rate of 100%. Additionally, laparoscopic surgery provides a definitive solution for postoperative intestinal obstructions, abdominal adhesions, or recurring partial obstructions.
Doctors also use laparoscopy to clean out large uterine fibroids with only minimal incisions. This is done by using a small drill to gradually extract the tissue samples without needing to enlarge the incision. Laparoscopic surgery allows for the treatment of very complicated conditions that are difficult to address with open surgery. Currently, laparoscopic procedures are applied across nearly all specialties, including: gallbladder removal, treatment of major bile duct stones, liver cystectomy, treatment of hiatal hernia and esophageal hernia, gastric resection, intragastric surgery, gastrojejunostomy, Taylor style vagotomy, gastrostomy, splenectomy for blood disorders, appendectomy, gastric perforation suturing, pancreaticogastrostomy, jejunal anastomosis, adhesiolysis and treatment of bowel obstruction and partial obstruction, thoracic sympathetic ganglionectomy, undescended testicular tumor removal, varicocelectomy, liver cystectomy, colectomy, and treatment of rectal prolapse. In summary, according to Professor Hoang Bac, everything related to surgery can be performed laparoscopically.
The ability to perform these procedures is due to laparoscopic surgery creating a larger operational space, better lighting, and clearer imaging, which allows for more meticulous maneuvers, thereby minimizing disruptions to immune function and nutrition. Patients increasingly prefer laparoscopic surgery because it addresses all the shortcomings of open surgery, such as: very small and short incisions of less than 5 mm, reduced pain, no complications, rapid recovery, earlier return to daily activities, and meeting aesthetic requirements.
However, to perform laparoscopic surgery, the facility must meet all conditions regarding personnel and supporting equipment. “Surgeons performing laparoscopic procedures must first be skilled in open surgery. Additionally, they need to be equipped with modern specialized devices along with a skilled technical team to operate and maintain this equipment,” Professor Bac stated regarding the requirements for performing laparoscopic surgery. “Therefore, not all places in Vietnam can currently perform laparoscopic surgeries.”
There are still some surgeries that are too complex and require open surgery. However, with the continuous advancements in technology and medicine, the future of laparoscopic surgery will gradually replace open surgery in all cases.
My Lan
