Abstract
Summary : Laparoscopic surgery for gastric cancer is thought to be less invasive and to offer results comparable to conventional surgery ; the use of this approach has increased remarkably. However in centers with little experience, a lack of technical expertise in laparoscopic lymph node dissection for gastric cancer can potentially affect the patients' cure rate and safety. An understanding of the advantages and disadvantages of laparoscopic surgery can decrease these risks. Therefore a questionnaire survey of institutions where laparoscopic surgery could potentially be used in gastric cancer patients was conducted. In 20 of the 28 institutions who responded such laparoscopic surgery was in fact being done, and 10 of the 20 were considered to be institutions with experience in the procedure, while 10 were considered to lack experience. Factors that affected outcomes were compared between the two groups. In both groups, the advantages of laparoscopy were primarily related to the good visualization offered by laparoscopy due to magnification or being able to view the field from an angle not possible during surgery. However, in the inexperienced institutions, the good visualization was offset by the inability to obtain good surgical fields. This inability might be the result of the surgeons' lack of expertise or the assistants inadequate technical abilities. To correct this situation, it is important to improve the operative teams' skill level.
