Human:Endocrinology ; Gynecologic surgical procedures ; Education, medical

Humans ; Laparoscopy/education* ; Female ; Gynecologic Surgical Procedures/education* ; Consensus ; Genital Diseases, Female/surgery* ; China ; Robotic Surgical Procedures/methods*

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.
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

OBJECTIVE: To assess the quality of life (QOL) of uterine cervical cancer patients after treatment in Korea and to demonstrate influencing factors. METHODS: 127 uterine cancer survivors, 107 controls of benign gynecologic surgery patients were interviewed with study questionnaire by research assistant. RESULTS: Participants were with the mean age of 54 years (cancer patients) and 43 years (controls). Physical component score of General QOL was statistically significant in uterine cervical cancer group compared with control group (p=0.049). Parts of MCS, CS-QOL, Emotional support, Coping efforts didn't show differences between two groups. In patients' characteristics, high economic status and advanced stage influenced patient's adaptation to treatment. When evaluating QOL including sexual function, most parts were statistically significantly worsen in uterine cancer patients, ie, sexual dysfunction (p=0.004), sexual discomfort (p=0.070), sexual pleasure (p=0.011), gynecological symptom (p=0.001). Most factors except age didn't influence sexual function deterioration between cancer group and control group. Common presenting concerns of cancer patients before treatment was health (51%), children (23%), economic problem (16%) but after treatment health (92%). The most helpful people were family members in 84% and physicians in 9%. CONCLUSION: Uterine cervical cancer survivors in Korea appear to experience greater distress on sexual function especially in young age. Therefore it is important for health care professionals to recognize that aspects of cancer survivorship continue to require education and adequate follow-up program.
Child ; Delivery of Health Care ; Education ; Female ; Follow-Up Studies ; Gynecologic Surgical Procedures ; Humans ; Korea* ; Pleasure ; Quality of Life* ; Surveys and Questionnaire ; Survival Rate ; Survivors ; Uterine Cervical Neoplasms* ; Uterine Neoplasms