離島における婦人科内視鏡手術の現状

抄録

Purpose: Although laparoscopy is a standard approach popularly used for a wide range of gynecological procedures, significant disparities exist across geographical areas, particularly in the remote islands of Japan. In this study, we investigated the current status of laparoscopy used for gynecological surgeries in hospitals across the remote islands of Japan.

Methods: Between May and July 2019, we performed a questionnaire survey to investigate the current status of gynecological laparoscopic surgery across 20 hospitals in 16 remote islands of Japan. We selected hospitals that employed at least one gynecologist who worked full-time.

Results: We received responses from 18 of 20 hospitals (90%); a single gynecologist worked full-time at 8 hospitals and at least two gynecologists worked at the other 10. Gynecological surgeries were performed at 12 hospitals, and of these, 6 hospitals performed laparoscopic surgeries. Notably, hysteroscopic surgeries were performed at only 2 hospitals.

No laparoscopic specialist certified by the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (specialist) worked at any hospital on a remote island; total laparoscopic hysterectomy under specialist guidance was performed only at 2 hospitals. Approximately two-thirds of the respondents surveyed at the hospitals were of the view that laparoscopic surgery should be performed even on remote islands.

Conclusions: We investigated the current status of gynecological laparoscopic surgery on remote islands of Japan and observed that not only gynecologists but even the residents of the islands were of the view that laparoscopic surgeries should be performed on these islands. Performing gynecological laparoscopic surgeries on the remote islands is challenging: however, it might be possible to introduce this technique in these geographical areas with appropriate specialist support.