My Encounters and Progress with Minimally Invasive Surgery

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology Evolution

Background:

• Gastrointestinal surgery initially relied solely on open abdominal procedures.
• The introduction of laparoscopic surgery in the late 1980s marked a significant shift towards less invasive techniques.
• Robotic surgery emerged as a subsequent advancement, further refining minimally invasive approaches.

Purpose of the Study:

• To document the personal experience and evolution of surgical techniques over a 41-year career.
• To highlight the transition from open surgery to laparoscopic and robotic procedures.
• To reflect on the impact of these technological advancements in gastrointestinal surgery.

Main Methods:

• Personal retrospective account of surgical practice at Juntendo University.
• Chronological overview of the adoption of open, laparoscopic, and robotic surgery.
• Inclusion of key dates for procedure introduction and insurance coverage in Japan.

Main Results:

• Laparoscopic cholecystectomy became the gold standard in Japan.
• Laparoscopic surgery for colorectal cancer evolved into less invasive techniques.
• Robotic surgery was adopted for prostatectomy and later for colorectal cancer, with significant case numbers by March 2025.

Conclusions:

• The author witnessed and participated in the transformative shift from open to minimally invasive surgical methods.
• Laparoscopic and robotic surgery represent major advancements in patient care and surgical outcomes.
• The integration of new surgical technologies has profoundly impacted the practice of gastrointestinal surgery.