Objective: To clarify how popularly the minimally invasive surgeries for urological tumors are currently conducted in Japan and to predict future trends.
Methods: A nation-wide survey was performed by the Japanese Association for Minimum-Incision Endoscopic Surgery under the support of the Japanese Urological Association (JUA). A questionnaire was sent to 1186 JUA-certified educational institutions asking about surgical practices for representative urological tumors performed in 2005 and those to be performed in the near future. Surgical modalities were categorized into open, laparoscopic and minimized-incision surgeries, defined as that the operator considers the incision to be minimal and including minimum-incision endoscopic surgery but not limited.
Results: 506 of the 1186 institutions (43%) responded and 20 193 surgical procedures were reported with radical prostatectomy being most frequently performed. Overall 20% and 6% of the procedures were performed with laparoscopic and minimized-incision surgeries, respectively. More than 20% of the respondents performed open surgery with reduced incision size than before. Surgical procedures without inserting fingers or hand were reported in 5-11% of the open surgeries and 33-45% of the minimized-incision surgeries. Endoscopy was utilized in 4-14% of the open surgeries and 24-59% of the minimized-incision surgeries. There was no difference in the incidence of complications among the surgical modalities. 40% and 27% of the respondents are aiming at laparoscopic surgery and at minimized-incision surgery, respectively.
Conclusions: The results of this nation-wide survey indicate that minimally invasive surgeries, currently performed in 26% of urological tumor surgeries, are aimed at by the majority of the survey respondents.