Introduction of minimally invasive surgery for the treatment of endometrial cancer in Japan: a review

Minimally invasive surgery is now becoming the standard surgical method for early stage endometrial cancer. In this review, we describe the path minimally invasive surgery has travelled from being an exceptional treatment to be the current standard in Japan. At the beginning of the 21th century, laparoscopic surgery has been employed for the treatment of gynecologic malignancies including cervical cancer and endometrial cancer. Robotic-assisted surgical system, which appeared a little later than laparoscope, has begun to be actively applied to surgical treatments for gynecologic malignancies that require particularly elaborate technologies. Both laparoscopic and robotic surgery have attracted the attention of surgeons because they enable safe, precise and less invasive surgery. Since the safety of minimally invasive surgery depends largely on the skill and experience of the surgeon, there is an urgent need to establish an educational system for implementing minimally invasive surgery. Here we describe various issues regarding minimally invasive surgery that Japan is currently facing, such as the medical economy, regulations by the Japanese health insurance system, a shortage of surgeons, the roles of academic organizations to educate surgeons and guide the appropriate implementation of minimally invasive surgery.