Minimally invasive spine surgery in Japan (from Laparoscopic surgery to foraminoplasty)

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Akira Dezawa


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Citation: A. Dezawa : Minimally invasive spine surgery in Japan (from Laparoscopic surgery to foraminoplasty) . The Internet Journal of Minimally Invasive Spinal Technology. 2008 Supplement I - to IJMIST Vol 1 No 2

Abstract

Japanese Society for the study of Endoscopic and Minimally Invasive Spine Surgery (JESMISS)has been found in 1998 and operated educational, scientific purposes or to do assist all those involved with health care and so on.　In 1995 endoscopic surgery was introduced for the first time. At first laparoscopic spine surgery, retroperitoneoscopic spine surgery has been tried. At September 1998 MicroEndoscopic Discectomy (MED) was introduced in Japan.　The number of posterior Endoscopic approach to the lumbar spine have gradually increased. So far about 12000 cases of posterior Endoscopic approach have already performed. On 13 May 2005 Japanese government has approved the application of endoscopic procedure to lumbar disc herniation. The controversy in applying the use of PELD (Percutaneous Endoscopic Lumbar Discectomy) and MED to treat the lumbar disc herniation remains an issue of discussion. But we try to use original PELD system with foraminoplasty since 2002 for the first time in Japan.
But the cause of intraoperative complications during this sophisticated surgery must be attributable to unrealistic and unpractical training system, shortage of experienced surgeons and no appropriate credentialing system. To overcome these problems, the Committee of Endoscopic Surgical Skill Qualification System was gained in JOA with 6 members who fulfill the requirements that are to be a councilor of JOA, a surgeon represents their Mother Society, a holder of certification by an appropriate specialty board and has established the credentialing system to encourage the surgeons to be trained to obtain privilege of endoscopic surgery. They shall serve for a 3 years term. As to the number of cases necessary to certify that the applicant must have a competence to be able to complete popularized endoscopic surgeries by his or her own efforts, surgeons must have an experience with over 30 cases in posterior lumbar discectomy or 20 cases in endoscopic anterior approach experience of some advanced endoscopic surgeries in the field of spine surgery.

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