Korean J Urol.  2015 Mar;56(3):170-178. 10.4111/kju.2015.56.3.170.

Current status of robotic surgery in Japan

• Nishimura

• KMID: 2133284
• DOI: http://doi.org/10.4111/kju.2015.56.3.170

Abstract

The da Vinci S surgical system (Intuitive Surgical) was approved as a medical device in 2009 by the Japanese Ministry of Health, Labour and Welfare. Robotic surgery has since been used in gastrointestinal, thoracic, gynecological, and urological surgeries. In April 2012, robotic-assisted laparoscopic radical prostatectomy (RALP) was first approved for insurance coverage. Since then, RALP has been increasingly used, with more than 3,000 RALP procedures performed by March 2013. By July 2014, 183 institutions in Japan had installed the da Vinci surgical system. Other types of robotic surgeries are not widespread because they are not covered by public health insurance. Clinical trials using robotic partial nephrectomy and robotic gastrectomy for renal and gastric cancers, respectively, have recently begun as advanced medical treatments to evaluate health insurance coverage. These procedures must be evaluated for efficacy and safety before being covered by public health insurance. Other types of robotic surgery are being evaluated in clinical studies. There are several challenges in robotic surgery, including accreditation, training, efficacy, and cost. The largest issue is the cost-benefit balance. In this review, the current situation and a prospective view of robotic surgery in Japan are discussed.

Keyword

Japan; Prostatectomy; Robotic surgical procedures

MeSH Terms

Cost-Benefit Analysis
Esophageal Neoplasms/surgery
Gastrectomy/*methods
Gynecologic Surgical Procedures/methods
Humans
Japan
Laparoscopy/*methods
Nephrectomy/*methods
Otolaryngology/methods
Prospective Studies
Prostatectomy/*methods
Rectal Neoplasms/surgery
Robotic Surgical Procedures/education/*trends
Stomach Neoplasms/surgery
Thymectomy/methods
Thyroid Diseases/surgery

Figure

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  Fig. 1 Number of robotic-assisted laparoscopic radical prostatectomy procedures performed for prostate cancer in Japan from 2008 to 2013. The results are from the 12th Japan Society for Endoscopic Surgery survey (2012, 2013) combined with the 10th (2008, 2009) and 11th (2010, 2011) surveys.

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  Fig. 2 Number of robotic-assisted partial nephrectomy procedures performed for renal tumors in Japan from 2010 to 2013. The results are from the 12th Japan Society for Endoscopic Surgery survey (2012, 2013) combined with the 11th (2010, 2011) survey.

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