Medical library at NTUH - Taiwan

I think that NTUH has a good library for every trainee (medical students, residents, fellows….). Medical library has a lot of book, textbook, documentary…, professional working method and a comfortable space for studying and searching.
Specially, medical library has a lot of new and update documentary, online searching stools…This thing is very important for studying in information society.
I have read and updated much knowledge about cardiothoracic surgery at medical library in here.

Educational method for resident at NTUH - Taiwan

I have joined all of meeting of CVS section and a number of meetings of thoracic section. I think that this training method will bring into play maximum ability of trainees and the other people. In the future, when I come back to Vietnam, I am going to persuade leaders and the other authorities for applying this training method (of course, we are going to apply but it has to suit with Vietnamese condition)
Morning meeting schedule of CVS section: All of day is reported by cardiovascular fellows with chairman of chief
- Monday: Morning meeting of CVS section
- Tuesday: Morning meeting of SICU section
- Wednesday: Morning meeting of CVS section
- Thursday: Meeting of heart transplantation
Contents of each morning meeting: Fellow is reporting all of situation of section, comment, questions…about patients who are treating at CVS section. At the end of each morning meeting, resident will present a case study by slide with reference… and they can bring out guideline or lecture about any patient (its special cases, severe patients, difficult patients)

Beating heart surgery for coronary stenosis disease at NTUH - Taiwan

The beating heart surgery is a sector that it has a lot of controversy in cardiac surgery. However, I am crazy about this surgery because experience of surgeon and they have performed very professional. I think that I have updated and consolidated much knowledge about this surgery (In Vietnam, we sometimes perform this surgery but not regular because all of Vietnamese surgeon don’t get used to it and they always prefer to CABG with CPB and cardioplegia)
Steps of beating heart surgery for coronary artery disease as follow:
- Supine, ETGA, midline sternotomy
- Harvest LIMA and SVG on the left
-Grafting to coronary arteries by LIMA and SVG. This thing is performed by beating heart or partial CPB (cardiopulmonary bypass)
-If beating heart: grafting LIMA -> LAD (the left anterior descending artery or a branch of left coronary artery) -> PDA (posterior descending artery – a branch of right coronary artery) -> OMs (a branch of circumplex artery).
-If partial CPB:
+ Cannulation via AsAo, SVC and IVC
+ On CPB, cooling to 28 - 300C
+ Grafting LIMA -> LAD (the left anterior descending artery or a branch of left coronary artery) -> PDA (posterior descending artery – a branch of right coronary artery) -> OMs (a branch of circumplex artery).
- Re-warm, de-air, wean off CPB
- Remove canuls
- Haemostasis
- Set drains
- Close wound in layers

Video-assisted thoracoscopic surgery for lung cancer at NTUH - Taiwan

In here, surgeons have performed VATS (video-assisted thoracocsopic surgery) very fluently and professional.
And I have also updated the new techniques about video-assisted thoracoscopic lobectomy in proper and VATS in general. From co-workers in here that I have improved skills in VATS, pre-operation indications, to know abnormal of operations and control it.
Be sure, I am going to apply update knowledge for practicing in my hospital and suitable with Vietnamese condition.

Orthotopic heart transplantation (HTx) at NTUH - Taiwan

Orthotopic heart transplantation hasn’t ever performed in Vietnam at the present but in the future (maybe the next year) it will be deployed and developed because this is an advanced treatment method for heart failure patients with the end stage and HTx’s potentiality is very good in Vietnam. In the future, knowledge about HTx that I have achieved in here, it is a steady base for participating to deploy HTx of my hospital.
Steps of orthotopic heart transplantation (HTx) as follow: (Have exact co-operation between heart transplantation team and team take donor)
- Supine, ETGA, midline sternotomy
- Cannulation via AsAo, SVC and IVC
- On CPB, cooling to 300C
- Remove heart of recipient and prepare heart of donor
- Orthotopic heart transplantation: to perform left atrium anastomosis  pulmonary artery anastomosis  aorta Cardioplegia  right atrium anastomosis
- Re-warm, de-air, wean off CPB
- Remove canuls
- Haemostasis
- Set drains
- Close wound in layers

Congenital heart surgery at NTUH - Taiwan

In Vietnam (my hospital), congenital heart surgery, adult heart surgery and thoracic surgery are work together but in here it is separation and it is very professional. However, I have selected and updated congenital heart surgeries that I will be practiced in my department when I come back to Vietnam for example atrium septal defect (ASD), ventricular septal defect (VSD), tetralogy of Fallot, atrio-ventricular canal… and in the future, we are going to deploy TGA, Truncus.
I have also updated knowledge about SICU in children hospital (about cardiovascular surgery) for example ECMO, intensive care for children after cardiac surgery…..
I can describe a congenital heart surgery as follow:
- Supine, ETGA, midline sternotomy (or redo-sternotomy)
- Cannulation via AsAo, SVC and IVC (bicaval)
- On partial CPB, hypothermia to 200C
- Ante-grade cardioplegia
- To approach and repair (partial or total) lesions of heart
- Re-warm, de-air, wean off CPB
- Remove canuls
- Temporary pericardial pacemarker
- Haemostasis
- Set drains

Đại cương về phẫu thuật nội soi lồng ngực

ĐỊNH NGHĨA VÀ CÁC KHÁI NIỆM VỀ PHẪU THUẬT NỘI SOI LỒNG NGỰC
1. Định nghĩa

1.1 Định nghĩa về phẫu thuật nội soi (endoscopic surgery)

Phẫu thuật nội soi là một phương pháp phẫu thuật xâm nhập tối thiểu sử dụng ống kính nội soi (scopes) và các dụng cụ nội soi chuyên dụng đi qua các lỗ nhỏ hoặc các lỗ tự nhiên trên cơ thể nhằm mục đích chẩn đoán và điều trị bệnh. Một thuật ngữ khác của phẫu thuật nội soi được sử dụng rộng rãi là phẫu thuật xâm nhập tối thiểu hay phẫu thuật ít xâm lấn (minimally invasive surgery – MIS)

1.2 Định nghĩa về phẫu thuật nội soi lồng ngực

Phẫu thuật nội soi lồng ngực là phương pháp phẫu thuật lồng ngực ít xâm lấn (hay xâm nhập tối thiểu) được thực hiện bởi tay và mắt qua trung gian là màn hình video với sự trợ giúp của các dụng cụ nội soi chuyên dụng

2. Các khái niệm cơ bản

2.1. Phẫu thuật nội soi lồng ngực kín (Closed thoracoscopic surgery – CTS)
Là phương pháp phẫu thuật xâm nhập tối thiểu được tiến hành với sự trợ giúp của ống kính nội soi (Thoracoscope) và các dụng cụ phẫu thuật nội soi mà đường mở ngực dưới 2cm

2.2. Phẫu thuật lồng ngực dưới sự trợ giúp của video (Video – assisted thoracic surgery - VATS): Là phẫu thuật nội soi lồng ngực với đường vào dưới 8cm được thực hiện qua sự phối hợp giữa ống kính nội soi và các dụng cụ nội soi chuyên dụng qua trung gian là màn hình video

Phẫu thuật nội soi lồng ngực trong điều trị các khối u trong lồng ngực

Phẫu thuật nội soi lồng ngực trong điều trị bệnh ra mồ hôi tay

Phẫu thuật nội soi lồng ngực trong cấp cứu

Phẫu thuật nội soi lồng ngực trong cắt thùy phổi