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Saiura. Mini-invasive Surg 2023;7:2 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2022.119

Editorial Open Access

System for the safe deployment of minimally

invasive pancreaticobiliary surgery in Japan

Akio Saiura
Department of Hepatobiliary-Pancreatic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan.

Correspondence to: Dr. Akio Saiura, Department of Hepatobiliary-Pancreatic Surgery, Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Tokyo 113-8421, Japan. E-mail: a-saiura@juntendo.ac.jp

How to cite this article: Saiura A. System for the safe deployment of minimally invasive pancreaticobiliary surgery in Japan. Mini-
invasive Surg 2023;7:2. https://dx.doi.org/10.20517/2574-1225.2022.119

Received: 21 Dec 2022 Accepted: 10 Jan 2023 Published: 17 Jan 2023

Academic Editor: Giulio Belli Copy Editor: Ke-Cui Yang Production Editor: Ke-Cui Yang

Abstract
The Japanese healthcare system is characterized by universal coverage and free access. It is an excellent social
system that allows everyone to receive advanced medical care at a low cost. Minimally invasive hepato-pancreato-
biliary (HPB) surgery in Japan is now covered by insurance. However, after experiencing a series of serious medical
accidents, Japan’s government requested a more advanced system to safely promote highly advanced surgery
including laparoscopic HBP surgery. As a practical measure, the academic societies of HPB surgery established a
new prospective registration system for all cases of minimally invasive HPB for highly advanced hepatobiliary and
pancreatic surgery while utilizing the existing technical certification system. Under these systems, hepatobiliary
and pancreatic surgeries in Japan are now being undertaken gradually but safely.

Keywords: Minimally invasive surgery, hepatectomy, pancreatectomy

INTRODUCTION
Japan is one of the most aged countries in the world (considering the percentage of elderly among the
[1]
population), which requires a specially prepared health system . Japan’s medical care is unique in two ways.
One feature is universal health insurance. While many countries have uninsured citizens, almost all citizens
in Japan are covered by public health insurance. This system was developed after World War II and has
greatly contributed to improving the average level of medical care in the country by providing high-quality,
low-cost, safe medical care to all citizens equally. However, Japan’s aging population and economic

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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