A patient with class III obesity (BMI 40) has successfully undergone gallbladder surgery (cholecystectomy) using the robotic Da Vinci Xi surgical system at FV Hospital (HCMC). This marks the first robotic surgery performed by the General Surgery Department, representing a significant expansion in the use of advanced technology to treat complex surgical conditions.
Surgical challenge of cholecystolithiasis in a class III obese patient
Mrs M.A.T., a 60-year-old Australian national, had been living with gallstones (cholecystolithiasis) for several years. As her symptoms progressively worsened and began to significantly affect her daily life and overall health, she decided to seek treatment at FV Hospital.
Following clinical examination and diagnostic imaging, Dr Phan Van Thai, MSc, Specialist Level 2 – Head of the General Surgery Department at FV Hospital, confirmed the presence of approximately ten gallstones ranging from 7 to 10 millimetres in diameter within the gallbladder. However, the primary surgical challenge was not the stone burden itself, but rather the patient’s physical condition: severe obesity with a BMI of 40.
“In patients with severe obesity, open surgery would require a considerably long incision, access to the operative field would be extremely complex, and the risk of post-operative complications would be significantly elevated. Even with conventional laparoscopic surgery, the thick layer of fat makes manoeuvring and visualisation more difficult,” Dr Thai explained.
Da Vinci Xi robotic system completely removes gallstones within 60 minutes
To maximise safety and optimise treatment outcomes, Dr Thai decided to use Da Vinci Xi, a leading, highly advanced robotic-assisted surgical system.
According to Dr Phan Van Thai, robotic surgery offers several key advantages over conventional laparoscopy: “The robotic arms can rotate and fold at flexible angles, allowing access to difficult anatomical areas. The 3D imaging system, magnifying by 10-20 times, provides a crystal-clear visualisation of blood vessels, nerves, and tissue layers, enabling much more precise dissection. As a result, the surgery proceeds smoothly with minimal blood loss, less pain, and a faster recovery for the patient.”
The procedure lasted just over an hour. Utilising the Da Vinci Xi’s flexible manoeuvrability and sharp magnified imagery, Dr Thai and his team removed all gallstones while perfectly preserving the surrounding vital structures.
The General Surgery team at FV Hospital performing robot-assisted gallstone surgery using the Da Vinci Xi system. (Image: FV)
Dr Wipawee Inthasotti (far left) congratulating doctors from FV Hospital’s Department of General Surgery following the successful procedure. (Image: FV)
Dr Wipawee Inthasotti, a robotic surgery specialist from Rajavithi Hospital in Thailand, who was present during the operation in an advisory role, said: “A patient with a high BMI presents a significant surgical challenge, but the FV surgeons demonstrated excellent control of the robotic system, with smooth and precise movements and meticulous preservation of critical structures like the cystic duct and cystic artery. The outcome was truly impressive!”
He further noted that the robotic system and operating theatre facilities at FV fully meet international standards, comparable to major surgical centres across the region.
Rapid recovery: Discharged within 24 hours
The most remarkable benefit of robotic surgery was evident in the post-operative period. Just one hour after the procedure, Mrs M.A.T. had regained consciousness and was transferred to the inpatient ward. “I hardly felt any pain, only some mild discomfort. It was amazing that I could go home the very next morning,” said Mrs M.A.T. cheerfully upon discharge.
Dr Phan Van Thai, MSc, Specialist Level 2 congratulating the patient on her discharge one day after surgery. (Image: FV)
The patient added that the attentive care from the nursing team, from reassuring her before anaesthesia to providing detailed post-operative instructions, helped a foreign patient like her feel at ease throughout the entire treatment process.
Expanding the scope of robotic surgery at FV
According to Dr Phan Van Thai, mastering robotic technology opens many opportunities to develop minimally invasive surgery within General Surgery, particularly for complex cases or high-risk patients.
“The transition from traditional laparoscopy to robotic-assisted laparoscopic surgery represents a leap forward for modern surgical practice. For complex procedures such as cancer treatment, robotic surgery enables surgeons to meet higher technical standards and optimise long-term treatment outcomes,” Dr Thai emphasised.
Dr Phan Van Thai, MSc, Specialist Level 2 head of the Department of General Surgery at FV Hospital, operating the Da Vinci Xi robotic system during the procedure. (Image: FV)
The recent successful deployment of robotic surgery across specialties including Thoracic Surgery and General Surgery not only affirms the technical proficiency of FV’s surgical team, but also lays the foundation for the development of FV’s dedicated Robotic Surgery Centre.
The da Vinci Xi system is currently being expanded for use across multiple medical specialties:
- Urology: prostate cancer, bladder cancer
- Gastroenterology: gastric and colorectal cancer (particularly tumours in anatomically narrow locations); hepato-pancreato-biliary and splenic surgery
- Gynaecology: uterine and ovarian cancer; uterus-preserving myomectomy
- Thoracic Surgery: lung cancer, mediastinal tumours, thymectomy for myasthenia gravis
To make advanced robotic surgical technology more accessible to patients, FV Hospital is offering a discount of VND40 million on robotic surgery procedures for the first 50 eligible cases, valid until June 15, 2026. For more information, please visit FV Hospital at 6 Nguyen Luong Bang Street, Tan My Ward, HCMC, or call (028) 3511 3333.
