The unnamed Cambodian national was diagnosed with a lesion in the upper lobe of her left lung, identified as a pulmonary mycosis. For six months, she persistently pursued a maximum-dose antifungal regimen at major hospitals in Cambodia, and even through treatment in Thailand.
The tumour, however, did not shrink. More dangerously, the patient occasionally coughed up blood. She then went to Vietnam and chose FV Hospital. Dr. Luong Ngoc Trung, head of Thoracic, Vascular and Endovascular Surgery, commented that the patient’s condition was like a “ticking time bomb”.
A pulmonary fungal mass (circled in red) located in the upper lobe of the left lung, adjacent to the airway and thoracic aorta, measuring over 4cm in diameter. Photo: FV
The lesion, measuring up to 4.6cm, was situated close to critical structures, posing a risk of vascular invasion or rupture into the airway. This could lead to sudden, life-threatening massive hemoptysis, a complication that may result in rapid death if not promptly managed.
Prolonged use of corticosteroids had caused the patient to develop complications such as myasthenia gravis. Meanwhile, long-term antifungal therapy may also impair liver and kidney function, further weakening the patient’s overall condition.
Robotic surgery
Faced with this urgent situation, doctors at FV Hospital decided to perform a lobectomy to completely remove the affected lung segment. Instead of conventional thoracoscopic surgery, the surgical team chose the da Vinci Xi robotic system to ensure maximum precision and safety.
Dr. Luong Ngoc Trung controls the da Vinci Xi robotic surgical system. Photo: FV
Dr. Trung said, “The robotic system enables gentle, flexible, and highly precise manipulation even in deep and narrow areas of the thoracic cavity, where critical structures such as major blood vessels and airways are located. This allows surgeons to handle complex procedures more accurately and safely.”
During the operation, surgeons controlled small robotic arms that manoeuvre within confined spaces, thereby minimising invasiveness and reducing postoperative pain.
In particular, for lesions located close to the airway as in this case, robotic assistance allows better control of surgical movements, facilitates the dissection of adhesions caused by prolonged inflammation, and minimises the risk of intraoperative rupture of the fungal mass.
The surgery lasted approximately 140 minutes and focused on completely removing the portion of the lung containing the fungal tumour, the core objective being to eliminate the source of the disease. After the surgery, the patient recovered quickly and was discharged from the hospital after only three days.
During the most recent follow-up visit, the patient’s health improved significantly. Notably, she can completely discontinue antifungal medication after prolonged use, while continuing to be monitored and treated for comorbidities such as Cushing’s syndrome and myasthenia gravis with an endocrinologist.
The surgical team at FV Hospital performed robotic lobectomy to treat pulmonary mycosis. Photo: FV
Pulmonary fungal infections can lead to serious complications, particularly sudden massive hemoptysis that can be life-threatening.
Doctors recommend that patients with persistent cough, hemoptysis, or poor response to antifungal therapy undergo thorough evaluation for timely intervention. Proper coordination between medical and surgical treatment plays a critical role in treatment effectiveness and long-term prognosis.
According to Dr. Trung, antifungal medication remains the mandatory first-line treatment for pulmonary mycosis, even when surgery is indicated. However, in cases where there is no response after intensive treatment – especially when the lesion is large and located near critical structures – surgical intervention becomes necessary for definitive treatment.
In such situations, robotic surgery enhances precision, improves safety during intervention, shortens recovery time, and helps reduce hospitalisation duration and associated costs.
Robotic surgery is currently applied at FV Hospital across multiple specialities, including general surgery, urology, thoracic surgery, gynecology, and oncology, and will continue to expand in the future. This contributes to improving treatment quality while minimising invasiveness for patients.
To successfully implement advanced robotic systems, FV Hospital is supported by a team of highly experienced specialists who are thoroughly trained in robotic surgery. All procedures are performed in operating rooms that strictly comply with international JCI standards, ensuring a sterile environment and minimising the risk of infection and complications.
To help patients make use of such advanced technology, FV Hospital is offering a discount of VND40 million ($1,600) for the first 50 da Vinci Xi robotic surgeries from now until June 15, 2026. For more information, please visit FV Hospital at 6 Nguyen Luong Bang street, Tan My ward, Ho Chi Minh City, or call (028) 3511 3333.
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