Breakthrough in laparoscopic surgery for liver cancer in Dong Nai

After eight years of performing open surgery for liver tumors and liver cancer, recently, doctors at Dong Nai General Hospital have mastered the technique of laparoscopic surgery to remove liver tumors and liver cancer.

This undertaking is a high-level technique that few provincial-level hospitals can perform. Thanks to this technique, many liver cancer patients who were hesitant about “major surgery” with open procedures have decided to undergo laparoscopic surgery to treat liver cancer.

Overcoming fear of surgery, many liver cancer patients successfully treated with laparoscopic surgery

With a history of chronic hepatitis B, Nguyen Kim Th., 47 years old (from Tri An commune, Dong Nai province), had not undergone regular monitoring or treatment due to financial hardship. In October 2024, she was diagnosed with liver cancer, with a sizable tumor measuring 5x5 cm. To preserve liver function, doctors performed transarterial chemoembolization (TACE) for patient Th. This method cuts off the tumor's blood supply while preserving as much healthy liver tissue as possible, thereby helping to prolong survival and improve quality of life.

However, this approach does not eliminate the tumor. Given the patient’s relatively young age and the presence of a significant volume of healthy liver tissue, doctors recommended laparoscopic surgery instead of a second TACE procedure during her hospitalization in mid-December 2025. This time, patient Th. agreed to undergo laparoscopic surgery to obliterate the tumor.

After eight years of performing open liver resection, recently, doctors at Dong Nai General Hospital have carried out laparoscopic surgery. Photo: Bich Nhan

With psychological fear of “surgical intervention” on a liver tumor, Nguyen Van B., 69 years old (from Ta Lai commune, Dong Nai province), repeatedly hesitated to undergo open surgery for his liver tumor. He underwent TACE twice, in June and September 2025. Recently, B. returned for follow-up and continued treatment. Based on clinical examination results, laboratory tests, and imaging diagnosis, doctors at Dong Nai General Hospital held a multidisciplinary consultation involving the General Surgery and Anesthesia - Resuscitation departments, then indicated laparoscopic surgery to resect the left liver lobe together with the tumor. On December 26, the operation was successfully performed, and the patient is continuing postoperative monitoring. It is expected that the patient will be discharged in a few days.

Recently, Duong Van V., 64 years old (from Bien Hoa ward, Dong Nai province), was diagnosed with liver cancer during a routine health check-up. The patient had no prior history of hepatitis B or C infection, nor any other chronic liver diseases. Based on clinical and paraclinical assessments, he was diagnosed with a liver tumor on a background of cirrhosis. However, the tumor was still small, and the estimated remaining volume of the left liver lobe after resection was about 40%, which met the safety threshold for laparoscopic surgery. Following a multidisciplinary consultation, doctors agreed to proceed with a laparoscopic right liver resection to remove the tumor definitively

Doctors performing laparoscopic liver resection at Dong Nai General Hospital. Photo: Bich Nhan

Doctor Nguyen Kim Kien, Specialist Level II, Deputy Head of the General Surgery Department, Dong Nai General Hospital, said that Viet Nam is among the countries with a high rate of hepatitis, and hepatocellular carcinoma is a serious problem. Eight years ago, doctors in the department performed liver resection (liver tumors) using open surgery. With this technique, doctors had to make an incision about two hand spans long from the chest toward the back to access the liver. “Therefore, many patients hesitated and were concerned about undergoing open surgery with a large incision, causing pain, prolonged recovery time, and affecting daily life after surgery”, doctor Kien said.

High-level technique, low cost while covered by health insurance

In this context, the introduction of laparoscopic liver resection is considered a significant advancement in the treatment of liver tumors and liver cancer at Dong Nai General Hospital. However, this procedure is highly complex and can only be performed by doctors who have received in-depth, systematic training, supported by modern operating room equipment to ensure surgical safety and effective control of complications during and after the operation.

With this technique, instead of making an incision about 40 cm long, doctors only need to make three small incisions of about 1-2 cm on the abdomen to insert instruments into the abdominal cavity, and a short incision at the pubic bone (similar to cesarean section surgery) to remove the liver tumor.

Doctor Nguyen Kim Kien shared: “Laparoscopic surgery to remove liver tumors and liver cancer is a modern technique that not many provincial-level hospitals can perform. However, this technique brings many benefits to patients such as minimal invasiveness, fewer complications, reduced postoperative pain, faster recovery with small and cosmetic surgical scars, shortened hospital stay, and lower treatment costs”.

Doctor Nguyen Kim Kien, Specialist Level II, Deputy Head of the General Surgery Department, Dong Nai General Hospital, also said that laparoscopic liver resection is particularly suitable for patients with liver tumors or liver cancer at stages where surgical intervention is still possible, with medium or small tumor size (under 5 cm), good liver function, and no cirrhosis.

Currently, liver cancer is quite common and has a high mortality risk. Therefore, for effective treatment, patients need early detection through liver cancer screening, especially those at high risk, such as people with cirrhosis, hepatitis B, or hepatitis C.

Not only does laparoscopic liver resection require highly skilled surgeons, but it also demands an experienced and highly specialized anesthesia team. Doctor Do Minh Vu, Specialist Level II, from the Anesthesia and Resuscitation Department, Dong Nai General Hospital, added that when receiving a laparoscopic liver resection case, the anesthesia team must develop a “strategy” to closely examine and monitor the patient before, during, and after surgery. In particular, during surgery, the anesthesia team must maintain low central venous pressure to prevent blood loss and ensure stable blood pressure.

“We have to closely monitor the patient and vital signs every second to make timely adjustments. Both the surgeon and anesthesiologist must coordinate carefully to ensure that the duration of hepatic pedicle clamping is not prolonged. When the hepatic pedicle is clamped, blood flow is halted to prevent bleeding, but if maintained for too long, it can lead to failure of other organs, such as the kidneys. Therefore, we clamp the hepatic pedicle for about 20 minutes to allow the surgeon to operate, then release it for five minutes to let the liver 'breathe,' ensuring that other organs continue to function properly after surgery,” doctor Do Minh Vu shared.

After surgery, since part of the liver has been removed, fluid and hydration replacement must be calculated very carefully to avoid affecting liver and kidney function. Although this technique has only been implemented recently, all patients undergoing laparoscopic liver resection at Dong Nai General Hospital have recovered well and were discharged after about four days.

It is estimated that each year, doctors perform open surgery on more than 100 patients with liver tumors and liver cancer. With the implementation of laparoscopic surgery, the number of patients willing to undergo laparoscopic procedures is expected to increase significantly compared to open surgery, especially since the cost of a single laparoscopic operation is just over 10 million VND and is covered by health insurance.

By Bich Nhan - Translated by Minh Hanh, Minho