Through continuous development, metabolic and bariatric surgery (MBS) has become widely recognized in academic and medical circles. In China, the volume of MBS operations has increased year by year. Therapeutic goals of MBS have evolved from treating obesity to treating Type 2 diabetes mellitus, and further to treating a series of obesity-associated metabolic diseases (including conditions in the endocrine system, circulatory system, respiratory system, reproductive system, and etc). Surgical approach of MBS has also been evolving continuously. Currently the common surgical procedures include laparoscopic Roux-en-Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy (LSG), laparoscopic adjustable gastric banding (LAGB) and bilio-pancreatic diversion with duodenal switch (BPD-DS). All surgical procedures have pros and cons, and the choice of surgical procedures should be based on the conditions of patients, the surgeon's technical ability, and benefits and operative risks. With the development of MBS, the proportions of different surgical procedures also changed in China. In recent five years, the proportion of AGB has decreased continuously and LAGB is no longer a common procedure. The proportion of LSG has increased rapidly, rising from 9% in 2010 to 55% in 2015. The proportion of RYGB has increased from 57% to 64% between 2010 and 2013, and remained at 45% afterwards. Since 2010, most MBS operations are laparoscopic surgery. 3D Laparoscopic surgery, laparoendoscopic single-site surgery and da Vinci Robotic Surgery have also been introduced in MBS. This review discusses the status quo and changes of MBS in china, as well as the new technology in MBS, aiming to strengthen the information and comprehension of MBS in china.
Bariatric Surgery ; methods ; statistics & numerical data ; trends ; Biliopancreatic Diversion ; statistics & numerical data ; trends ; China ; Diabetes Mellitus, Type 2 ; surgery ; Disease Management ; Endoscopy, Digestive System ; statistics & numerical data ; trends ; Gastrectomy ; statistics & numerical data ; trends ; Gastric Bypass ; statistics & numerical data ; trends ; Humans ; Laparoscopy ; statistics & numerical data ; trends ; Metabolic Diseases ; surgery ; Obesity ; surgery ; Robotic Surgical Procedures ; statistics & numerical data ; trends

There are vast land and lots of people in western China, but the economy developing is relatively slow. However, the minimally invasive surgery was carried out firstly in China. Moreover, the type, number and difficulty of the minimally invasive surgery increased year by year. Especially, in the western area of China, Dr Zhou Zongguang, Yu Peiwu and Zheng Shuguo et al. have performed much pioneering work in laparoscopic surgery for rectal cancer, gastric cancer and laparoscopic liver resection. They led the standard development of minimally invasive in China. In the future, western China should continue to strengthen the standardized training of minimally invasive surgery, make great effort to carry out evidence-based research of minimally invasive surgery, provide evidences of high level of clinical application in minimally invasive surgery. At the same time, we should carry out the robotic and 3D laparoscopic surgery actively, leading the development of minimally invasive surgery more standardized and more widespread in western China.
China ; Digestive System Surgical Procedures ; methods ; trends ; Evidence-Based Medicine ; Hepatectomy ; methods ; Humans ; Laparoscopy ; methods ; Minimally Invasive Surgical Procedures ; education ; methods ; standards ; trends ; Rectal Neoplasms ; surgery ; Robotic Surgical Procedures ; Stomach Neoplasms ; surgery

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

No abstract available.
Humans ; Laparoscopy/methods ; Minimally Invasive Surgical Procedures/*methods ; Periodicals as Topic ; Robotic Surgical Procedures/*methods ; Urolithiasis/diagnosis/therapy ; Urologic Surgical Procedures/*methods ; Urology/trends

Minimally invasive surgery, which has been extensively used to treat gastric adenocarcinoma, is now regarded as one of the standard treatments for early gastric cancer, and its suitability for advanced gastric cancer is being investigated. The use of cutting-edge techniques for minimally invasive surgery enables surgeons to deliver various treatment options to minimize a patient's distress and to maintain oncologic safety. Ongoing multicenter prospective studies aim to validate the efficacy of these surgical techniques and to expand the indications of minimally invasive surgery for the treatment of gastric cancer. In this review, we summarize the current status and issues regarding minimally invasive surgery for the treatment of gastric cancer.
Gastrectomy/*methods/trends ; Humans ; Laparoscopy/*methods/trends ; Multicenter Studies as Topic ; Patient Selection ; Randomized Controlled Trials as Topic ; Republic of Korea ; Robotic Surgical Procedures/*methods/trends ; Sentinel Lymph Node Biopsy/methods/trends ; Stomach Neoplasms/*surgery

Humans ; Laparoscopy ; methods ; trends ; Pancreaticoduodenectomy ; methods

Common Bile Duct ; surgery ; Gallstones ; surgery ; Humans ; Laparoscopy ; methods ; trends

Humans ; Laparoscopy ; methods ; trends ; Urology ; methods

Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical system is now in widespread use in many countries where economic conditions allow the installation of this expensive technology. Controversy has surrounded the procedure since it was first performed in 2000, with many critics highlighting the lack of evidence to support its use. However, despite the lack of level I evidence, many large studies of patients have confirmed that the procedure is feasible and safe, with low morbidity. Available longer-term oncological data seem to show that outcomes from the robotic approach at least match those of traditional open radical prostatectomy. Functional outcomes also seem satisfactory, although randomized controlled trials are lacking. This paper reviews the current status of RALRP with respect to perioperative data and complications and oncologic and functional outcomes.
Erectile Dysfunction ; etiology ; Humans ; Laparoscopy ; methods ; trends ; Male ; Prostatectomy ; adverse effects ; instrumentation ; methods ; Prostatic Neoplasms ; surgery ; Robotics ; methods ; trends ; Treatment Outcome ; Urinary Incontinence ; etiology

INTRODUCTIONThe traditional approach for the treatment of endometrial cancer by laparotomy is increasingly being replaced by laparoscopic surgery. The advantages of laparoscopy have been well-documented. Laparoscopy avoids the morbidity of a laparotomy, overcomes the limitations of vaginal hysterectomy, provides adequate pathological information for an accurate surgical staging and expedites the postoperative recovery of patients. This paper reports the outcome of a series of 50 consecutive cases of laparoscopic hysterectomy and pelvic lymphadenectomy for endometrial cancers that were performed by the author. The objective is to review the perioperative, postoperative experience and survival outcomes of patients with endometrial cancer managed by laparoscopic surgery performed by a single surgeon.

MATERIALS AND METHODSThe records of 50 consecutive patients with endometrial cancers from October 1995 to October 2007 treated by laparoscopic pelvic lymphadenectomy and laparoscopic hysterectomy (total and assisted) were retrospectively reviewed. Data on patients' attributes, endometrial cancers, surgical procedures, surgical complications and morbidity, perioperative experience, length of hospital stays and clinical outcome were analysed.

RESULTSLaparoscopic surgery was successful in all 50 patients and is clearly an option for the treatment of early endometrial cancer.

CONCLUSIONCareful patient selection and surgical competency are instrumental in ensuring successful treatment.

Adenocarcinoma ; mortality ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Endometrial Neoplasms ; mortality ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Laparoscopy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; epidemiology ; Pelvis ; Retrospective Studies ; Survival Rate ; trends ; Treatment Outcome ; Young Adult