On 2/3, Master of Science, Doctor of Medicine, Level 2 Specialist Nguyen Van Viet Thanh, Head of Thoracic and Thyroid Surgery at Binh Dan Hospital, stated that the patient had a rare congenital anomaly called intralobar pulmonary sequestration. He was unaware of this condition for decades until a recent health check-up.

Doctors identified an abnormally developed piece of lung tissue (23x26 mm) in his left lower lung lobe. This tissue had no respiratory function, was not connected to normal airways, and was parasitic, receiving its blood supply directly from the thoracic aorta. Notably, the arterial branch feeding this extra lung tissue had a diameter of up to 17 mm, a very large size that could rupture at any moment.

According to medical literature, pulmonary sequestration accounts for approximately 0,15-6,4% of congenital lung anomalies, affecting men three times more often than women. Under the extremely high blood pressure from the aorta, the fragile blood vessels of this extra lung could rupture at any moment, causing massive hemoptysis or a sudden hemorrhage into the pleural cavity, leading to instant death. Furthermore, lacking a drainage pathway, this lung mass could easily become a bacterial reservoir, causing recurrent pneumonia and abscesses. The abnormal blood flow could even overload the heart, leading to heart failure or degenerating into cancer.

Surgery is the only definitive treatment for this condition. However, dissecting this arterial branch presents many challenges. The blood vessels are large, fragile, and tightly adhered due to chronic infection in the surrounding area. A minor error, even a deviation of a few millimeters, could lead to uncontrollable bleeding, posing an immediate life threat on the operating table.

Image of the patient's extra lung tissue on a scan. *Photo: Hospital provided*

Previously, doctors often performed open surgery to treat such cases, which caused patients significant pain and blood loss. Traditional laparoscopic surgery offered limited maneuverability. For this case, doctors decided to apply robotic surgery, the most advanced technology available today. This marks the first recorded robotic pulmonary sequestration resection in Vietnam.

Equipped with a camera providing sharp 3D images and robotic arms capable of flexible 720-degree rotation, "more agile than human hands", doctors could navigate into the deepest corners of the chest cavity. The system also filters out natural hand tremors, allowing for the dissection and ligation of blood vessels near the aorta to be performed with absolute precision.

After 120 minutes, doctors completely removed the pulmonary sequestration. The patient had only a few very small incisions, resulting in minimal pain, no blood loss, and a spectacular recovery. He was discharged 4 days after surgery.

Doctor Thanh advised the public that if they experience symptoms such as hemoptysis, recurrent pneumonia in a fixed location, or detect an abnormal lung mass via CT scan, they should immediately visit specialized medical facilities for screening and to remove this "ticking time bomb" before complications arise.

Le Phuong