Nghe An General Friendship Hospital successfully performs many advanced techniques of the Central level.

Laparoscopic liver resection and pancreaticoduodenectomy

Recently,Nghe An General Friendship Hospitalhas successfully implemented laparoscopic liver resection and laparoscopic pancreaticoduodenectomy. These are two advanced techniques at the central level. The successful implementation of the technique at the hospital has brought great benefits to patients in the province as well as the North Central region.

Information fromNghe An General Friendship Hospital: In the past, in hospitals, to perform liver resection and pancreaticoduodenectomy, doctors had to perform open surgery. The large incision, cutting through many muscle systems, caused the patient a lot of pain and required a long recovery time...

The patient underwent liver resection and pancreaticoduodenectomy using open surgery. Photo: BVCC

To overcome this, since May 2020, the hospital has sent a team of doctors from the Department of General Surgery to train in laparoscopic liver resection and laparoscopic pancreaticoduodenectomy at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City (this is a medical facility that has implemented these two techniques very early and achieved breakthrough successes, recognized by the World Hepatobiliary and Pancreatic Association as well as Vietnam).

October 2020,Nghe An General Friendship Hospitalbegan to perform the first laparoscopic liver and pancreaticoduodenectomy. With the knowledge they had learned, the doctors of the General Surgery Department applied it flexibly and effectively, bringing success to the surgery.

Laparoscopic surgery to resect the left lobe of the liver. Photo: BVCC

Doctor CKII Le Anh Xuan - Head of General Surgery Department shared: "Endoscopic surgery is a minimally invasive surgery for patients, bringing many advantages such as: quick recovery after surgery, less pain for patients, cosmetic surgical scars and shortened hospital stay as well as treatment costs; while the treatment effectiveness is equivalent, even higher than open surgery.

Patients indicated for laparoscopic liver resection are those with benign liver tumors (large hemangioma, adenoma, etc.) or malignant liver tumors (liver cancer, bile duct cancer, liver metastasis, etc.). Patients who are indicated for laparoscopic pancreaticoduodenectomy are those with tumors of the common bile duct, head of the pancreas, duodenum, etc. When the Hospital performed laparoscopic liver resection and laparoscopic pancreaticoduodenectomy, patients were very grateful and appreciated it.

With laparoscopic surgery, patients recover quickly, have less pain, have cosmetic surgical scars, shorten hospital stays, and are less expensive to treat. Photo: BVCC

Up to now, after more than 2 years of implementation (in the context of fighting the Covid-19 epidemic), the Department of General Surgery has performed more than 30 laparoscopic pancreaticoduodenectomy and laparoscopic liver resections. All cases were performed successfully. 100% of patients who underwent surgery are in good health, have normal activities and are regularly re-examined and checked at the hospital.

At the 2022 National Conference on Surgery and Endoscopic Surgery, doctors from Nghe An General Hospital reported initial summary studies on laparoscopic liver resection and laparoscopic pancreaticoduodenectomy and received great attention and appreciation from domestic and foreign scientists.

With the increasing rate of cancer patients, including liver cancer and pancreaticoduodenal-biliary tract cancer, laparoscopic surgery is a legitimate need of patients. Nghe An General Hospital is a reliable and quality address to help patients overcome death, regain life and improve the quality of life later.

Brachial plexus paralysis recovery

Also information from Nghe An General Hospital: In November 2022, the Hospital successfully implemented the surgical technique to treat brachial plexus paralysis for 2 patients. This is also a high-level technique at the central level, performed by hospitals in Hanoi and Ho Chi Minh City; up to now, no provincial or regional hospital has been able to perform it. The successful implementation of the technique has opened up opportunities for patients in the province and region to be treated at a lower cost.

Brachial plexus paralysis, also known as hand paralysis, is caused by trauma from traffic accidents, domestic accidents, and weapons such as scissors and knives. Brachial plexus paralysis caused by traffic accidents accounts for a very high rate. The disease is divided into two levels: complete paralysis and incomplete paralysis.

The patient suffered from brachial plexus paralysis, also known as hand paralysis, due to trauma from a traffic accident. Photo: BVCC

When the brachial plexus is paralyzed, the golden time to perform is 3-6 months (from the time of injury). Later, the patient's wound will fall into a state where the muscles begin to show signs of degeneration and fibrosis, the nerves are quite damaged, finding the damaged nerve is very difficult. When the nerve is newly severed and reconnected in time, the recovery ability is very high, almost returning all motor functions to the patient.

Dr. Nguyen Duc Vuong - Head of the Department of Trauma and Orthopedics, Nghe An General Hospital said: Surgery to treat brachial plexus paralysis involves connecting, grafting and transferring nerves. In addition, there is muscle transfer to restore function.

If the injury is new and the nerve is severed, we must reconnect it. If the injury is old and the nerve is severed and has degenerated for a long period, we may have to graft a segment of nerve from another place to make a graft from the donor nerve (phrenic nerve, 11th nerve, intercostal nerve, contralateral C7 nerve, contralateral 11th nerve) to the recipient nerve (suprascapular nerve, biceps nerve, superior most nerve or lateral fasciculus nerve). Another method is muscle transfer in the treatment of delayed paralysis, where the muscle is severely damaged and the nerve graft is ineffective.

Taking a motor nerve from the donor site and transferring it to the paralyzed site does not affect the patient's current function much. For example, if we cut and transfer the 11th nerve to the recipient nerve, the patient can still lift his shoulder without much weakness because we only take one branch. Or taking the phrenic nerve or the intercostal nerve will not affect the patient's respiratory function much. Taking the C7 nerve on the opposite side will still allow the patient to flex and extend the elbow.

After treatment, the patient's arm will gradually regain function, ensuring good service for his daily activities. Photo: BVCC

Dr. Nguyen Duc Vuong - Head of the Department of Trauma and Orthopedics added: The problem of nerve recovery is no different from that of bones and joints, but the rate of nerve healing is slower. In addition, the patient's feeling of not being able to move is very uncomfortable, so nerve recovery always takes longer than bones and joints. However, it is not completely long because there are cases where the organ is torn right at that muscle area, the muscle connection will recover very quickly. Patients need to persevere in recovery treatment for a relatively long time, which can be calculated in years.

It is known that in the past, there were quite a lot of patients with brachial plexus paralysis in Nghe An. When admitted to the hospital, provincial hospitals could not treat them and had to transfer them to higher levels. In order to meet the actual requirements of the local disease model, from July to October 2022, Nghe An General Hospital sent a team of doctors from the Department of Trauma and Orthopedics to study brachial plexus surgery at Hospital 108. By October 2022, this technique was completely transferred, and by November 2022, the hospital's doctors had mastered the technique.

Associate Professor, Dr. Nguyen Van Huong - Director of Nghe An General Hospital shared: In recent times, Nghe An General Hospital has constantly overcome difficulties, actively implemented human resource training programs, renovated infrastructure, equipment and supplies to serve the development of specialized and cutting-edge technical expertise to better serve the work of medical examination and treatment, and health care for the people of Nghe An and in the region. This is extremely meaningful for patients, helping them enjoy modern and specialized medical services and techniques without having to transfer to other hospitals, reducing medical examination and treatment costs. In the coming time, Nghe An General Hospital will continue to promote the development of advanced and specialized techniques in the North Central region...

Thanh Chung