Current Status And Challenges Of MIS In Asia: From Laparoscopic Surgery To Foraminoplasty Using 2mm Fine High-Speed Bur
A Dezawa. Current Status And Challenges Of MIS In Asia: From Laparoscopic Surgery To Foraminoplasty Using 2mm Fine High-Speed Bur. The Internet Journal of Minimally Invasive Spinal Technology. 2006 Volume 1 Number 1.
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 Micro Endoscopic Discectomy (MED) was introduced in Japan and China. The number of posterior Endoscopic approach to the lumbar spine has gradually increased. So far about 19000 cases of posterior Endoscopic approach have already performed in Japan. 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 in Asia. Foraminoplasty have been developed in Korea and Taiwan since 2001. We developed the technique of foraminoplasty in case of foraminal stenosis using the fine (2mm in diameter) high-speed bur 2 years ago. 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 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.
With this approach, it is considered that liability as the certificate holder of Endoscopic Surgical Skill Qualification will let them contribute to further development of endoscopic surgery. Moreover we believe that the qualified surgeons are able to lead the endoscopic surgery to a correct direction through their daily activities in individual geographical location.