AB003. Future prospects of urologic robotic surgery in Japan

Abstract: Robotic surgery has a promising role in increasing the acceptability of urologic surgery. Since the approvement of medical insurance for radical prostatectomy, the number of cases is rapidly increasing, reaching to 12,000 in 2015. In contrast, the number of partial nephrectomy was only 382 in 2015. Based on many reports concerning the benefits of robotic partial nephrectomy (RAPN) over conventional laparoscopy in terms of a shorter warm ischemia time, learning curve, renal function, and so on, we performed prospective Japanese Clinical Trial of RAPN in 14 institutes controlled under Advanced Care Medicine B. The achievement rate of warm ischemic time <25 min and negative surgical margin rate were designed as the primary endpoint and compared with those of LPN (Japanese clinical data). According to the results that the achievement rate of the primary endpoint in RAPN was much better than that in LPN and that RAPN, the medical insurance was approved for partial nephrectomy on this April. Since that, the number of case is increasing and around 2,000 cases were already performed. We are trying to get the approvement of insurance for another procedure. However, it is very difficult to find the best primary end point over conventional laparoscopic surgery so far. Additionally, we collaborate with the industry to develop new robotic surgical system. I hope that this system will reduce the cost and make robotic surgery more common in several procedures in Japan.

Keywords: Urologic; robotic surgery; radical prostatectomy; partial nephrectomy