FV surgeons use robotic technology to remove complex thyroid cancer lymph nodes, saving Cambodian patient from two major surgeries

Instead of undergoing two high-risk operations to treat multiple metastatic lymph nodes located deep within the mediastinum on both sides of the chest, a Cambodian female patient underwent a single procedure using the da Vinci Xi robotic surgical system at FV Hospital. The surgical team successfully removed all suspected metastatic lymph nodes from both sides of the chest in one operation.

Just two days after surgery, the patient was well enough to be discharged and return home, a remarkably smooth recovery that felt more like a short holiday in Vietnam than recovery from a major operation – something even she found hard to believe.

Extensive lymph node spread on both sides of the chest left patient facing the prospect of two major operations

Ms K.S. (47, Cambodian) was admitted to hospital with thyroid cancer that had spread to her cervical (neck) lymph nodes and deep into both sides of her mediastinum (the central area of the chest cavity).

Before coming to Vietnam, she had consulted several hospitals in her home country. All reached the same conclusion: large number of deeply positioned lymph nodes spread across both sides of the chest would require two separate operations. This approach would expose her to multiple rounds of general anaesthesia, prolonged treatment times, and a significantly higher risk of complications.

After reviewing the scans and conducting a multidisciplinary consultation, Dr Dang Dinh Minh Thanh, PhD, Specialist Level II – Head of the FV da Vinci Robotic Surgery Centre and Head of Thoracic Surgery – determined that this was an exceptionally complex case. The difficulty lay not only in the deep location of the nodes, with several measuring more than 3 cm, but also in their bilateral distribution across the mediastinum, an area notoriously difficult to access, even through conventional keyhole surgery.

Furthermore, in thyroid cancer cases, if metastatic lymph nodes are not completely removed, the effectiveness of subsequent radioactive iodine treatment may be significantly reduced. As a result, the operation required an extremely high level of precision at every stage of the procedure.

Robotic surgery: Thoroughly removing cancer lymph nodes from both sides of the chest in a single operation

“If we had followed conventional methods, splitting the treatment into two separate operations would almost have been unavoidable,” Dr Thanh explained regarding K.S.’s case. Instead of the traditional route, the surgical team decided on a bolder approach: removing all lymph nodes from both sides of the chest in a single session, using the advanced capabilities of the robotic arms.

“Robotic surgery allows flexible maneuvering within confined spaces and offers highly precise access to deep anatomical areas. This enabled us to tackle all the lymph nodes in just one operation,” Dr Thanh added.

During the procedure, conducted by Dr Thanh and his team, every step was supported by the da Vinci Xi robotic system, one of the world’s most advanced robotic technologies.

Compared to open surgery, the robotic arms can rotate, extend, and bend up to 540 degrees with exceptional flexibility. This allows them to navigate skillfully into the narrowest regions deep within the chest. Meanwhile, the 3D camera provides a high-definition image magnified 10 times, giving the surgeon a crystal-clear view of every minute structure to dissect the lymph nodes with utmost precision. This capability allowed the team to address lesions on both sides of the mediastinum simultaneously, a feat highly difficult to achieve through standard keyhole (laparoscopic) surgery. Crucially, the robot operates through incisions of just 8mm, leaving no large scars, which are common in traditional surgery.

After just over two hours in theatre, all suspected metastatic lymph nodes were successfully removed. K.S. shared that she experienced minimal pain, allowing her to recover rapidly. Her hospital stay was also significantly reduced; after just two days, she was able to move around and resume daily activities almost as normal. She herself could hardly imagine that her treatment could be so swift and effective.

According to Dr Thanh, completely removing suspected metastatic lymph nodes is essential in thyroid cancer treatment, as any remnants can compromise the effectiveness of subsequent therapies, such as radioactive iodine. “Beyond curing the disease, we always prioritize the patient’s post-operative quality of life, from pain management and recovery time to cosmetic outcomes,” the Head of Department emphasised.

More patients choose robotic surgery for rapid recovery and high effectiveness

Robotic surgery is now available at FV Hospital across various specialties, including urology, gastroenterology, and thoracic surgery, with its scope of application continually expanding.

Beyond the technology itself, clinical success relies heavily on close multidisciplinary collaboration and the expertise of a highly trained surgical team. As a result, patients with complex conditions, particularly those in challenging anatomical areas, now have an option for minimally invasive treatment that still ensures the thorough removal of disease.

Robotic surgery offers many advantages, including less post-operative pain, faster recovery, shorter hospital stays and minimal scarring. This is one of the reasons why more patients are choosing this approach for a smoother and safer treatment experience.

One of the reasons more patients are confidently choosing robotic surgery is that FV Hospital has recently launched a support programme, offering a VND 40 million reduction for the first 50 patients undergoing surgery with the da Vinci Xi robotic system, valid until 15 June 2026. Readers can find more information by visiting FV Hospital at 06 Nguyen Luong Bang, Tan My Ward (former District 7), Ho Chi Minh City, or by contacting (028) 3511 3333.