An Israeli patient suffering from a substantial 6 x 10 x 10 cm oesophageal tumour, located dangerously close to the heart, initially faced the daunting prospect of oesophageal resection and reconstruction. However, the surgical team at FV Hospital successfully utilised the advanced da Vinci Xi robotic system to perform complete tumour removal, preserving the patient’s natural oesophagus.
Emergency Admission for Acute Chest Pain Reveals Large Tumour Behind the Heart
Mr N.D., a 31-year-old Israeli national, was admitted to the Accident and Emergency Department in the middle of the night with severe chest pain in the epigastric region. Diagnostic imaging revealed a large mediastinal mass positioned directly against the heart. The tumour appeared to originate from the lower third of the oesophagus, with clinical findings suggesting internal haemorrhage.
Dr Pham Luu Nhat Hoang, Specialist Level II and Deputy Head of the Accident and Emergency Department, noted that within just two hours of admission, FV had completed comprehensive diagnostic testing and convened a consultation with the Thoracic Surgery Department. “The speed of our interdisciplinary coordination significantly accelerated both the diagnosis and the final treatment decision,” he said.
The hospital’s medical team quickly transferred the patient to the operating theatre. (Photo: FV)
The patient was diagnosed with a submucosal oesophageal tumour showing signs of internal bleeding. A traditional endoscopic biopsy posed a severe risk of triggering a major haemorrhage. This created a complex clinical dilemma. Although the benign or malignant nature of the mass had not yet been confirmed, surgery could not be delayed due to the imminent threat of further bleeding.
Multidisciplinary Consultation Prepares for Multiple Surgical Scenarios
During a multidisciplinary consultation, the FV medical team developed several surgical plans depending on the nature of the tumour. If the tumour was found to be benign and could be safely removed, the oesophagus would be preserved. However, if it was malignant or if the oesophageal wall could not be securely closed after excision, surgeons would have to remove a portion of the oesophagus and reconstruct it using a gastric conduit.
Dr Dang Dinh Minh Thanh, PhD, Specialist Level II and Head of the FV da Vinci Robotic Surgery Centre, described the case as highly complex. The mass, measuring approximately 6 x 10 x 10 cm, was located immediately adjacent to the heart, an anatomical location that is extremely difficult to access. Given the confined operating space, the intricate surrounding structures, and the high risk of haemorrhage, robotic-assisted surgery was considered the most appropriate approach.
The procedure was performed by Dr Thanh using the da Vinci Xi system, the most advanced generation currently available in Southeast Asia. Compared with conventional laparoscopy, the da Vinci Xi provides high-definition 3D imagery with exceptional clarity and tremor-filtration technology. This enables surgeons to operate with greater flexibility and precision within the narrow mediastinal space behind the heart.
During the operation, the team performed a frozen section biopsy to rule out carcinoma. Upon dissection, the mass was identified as a cyst with a wall nearly 1 cm thick, containing old blood, evidence of previous internal bleeding that had caused the patient’s acute pain. Following complete tumour removal, the remaining oesophageal wall was assessed as sufficiently secure for primary closure. The surgery was a resounding success, preserving the young patient’s natural oesophagus.
Dr Thanh examines the patient following surgery (Photo: FV)
Remarkably, just two hours after the operation, the patient was conscious and in good spirits. Subsequent tests for oesophageal leakage returned negative, and pathology results confirmed the tumour was benign.
Notably, the patient’s family had initially considered repatriating him to Israel for treatment. However, after the clinical team explained the unpredictable risk of re-haemorrhaging, which would be life-threatening during a long-haul flight, the family decided to proceed with surgery at FV Hospital. The patient shared that he chose FV due to its proximity to his home and the fact that his relatives had previously received successful treatment there. “I believe I came to the right place,” he said, visibly moved.
Robotic surgery: A Breakthrough in the Treatment of Complex Thoracic Conditions
According to Dr Dang Dinh Minh Thanh, PhD, Specialist Level II, the success of this procedure highlights the increasingly important role of robotic surgery in the treatment of complex thoracic conditions, particularly large oesophageal tumours located in difficult anatomical locations.
“Robotic surgery enhances precision, reduces invasiveness, minimises the need to convert to open surgery, and significantly shortens recovery times. These are distinct advantages, especially for high-risk cases,” Dr Thanh emphasised.
The da Vinci Xi robotic surgical system at FV Hospital (Photo: FV)
The da Vinci Xi robotic system was officially commissioned at FV Hospital in early 2026. Following the positive outcomes of initial procedures in thoracic and general surgery, the hospital is continuing to expand the use of this technology across a range of medical specialities:
- Urology: Treatment of prostate and bladder cancers.
- Gastroenterology: Surgery for gastric and colorectal cancers, particularly for tumours in hard-to-reach areas.
- Gynaecology: Treatment of uterine and ovarian cancers, as well as myomectomies aimed at uterine preservation.
- ENT (Ear, Nose, and Throat): Surgery for tumours in the head and neck region.
To help patients access this advanced surgical technology early, FV Hospital is offering financial assistance of VND 40 million for 50 robotic surgery cases, valid from now until 15 June 2026. For further information and consultation, patients may visit FV Hospital, 06 Nguyen Luong Bang Street, Tan My Ward, Ho Chi Minh City, or contact (028) 3511 3333.
