In response to last year’s scandal in which a number of patients died after undergoing laparoscopic liver surgery, two key medical bodies have introduced a system to track such procedures to ensure safety and transparency.
The Japanese Society of Hepato-Biliary-Pancreatic Surgery and the Endoscopic Liver Surgery Study Group on Wednesday announced the launch of a system that registers cases of laparoscopic liver surgery, with hospitals asked to provide records.
“The system aims to verify the safety of laparoscopic liver surgeries,” Hiroyuki Nitta, an instructor at Iwate Medical University’s surgery department who is charged with administrative aspects of the surgery study group, told The Japan Times on Thursday. “It is also aimed at studying what types of liver problems are suited to surgery using a laparoscope.”
Laparoscopic surgery requires only a small incision and causes less pain to patients than conventional abdominal surgery. However, it requires a high level of surgical skill as the procedure carries the risk of damaging tissues and blood vessels outside the camera’s visual field.
The safety and transparency of the highly technical surgery were called into question after a series of post-surgery deaths were reported last year at Gunma University Hospital in Maebashi and Chiba Cancer Center in the city of Chiba.
In March, the hospital belonging to the national university admitted negligence in the deaths of eight patients following laparoscopic liver surgery. They died within four months of the procedures, all conducted by one surgeon between 2010 and 2014, according to the hospital.
The system, already in operation from Oct. 1, calls on more than 200 major medical institutions nationwide that have conducted laparoscopic liver surgery to report on the operations at three or four stages: immediately before and after the surgery, at the time of patient discharge and when the patient is readmitted to hospitals, if it happens within 90 days of the operation.
Nitta, who is a surgeon specializing in hepato-biliary-pancreatic and endoscopic liver surgeries, said the society and the study group previously conducted hospital surveys on endoscopic liver surgery, but they were based on a once-a-year questionnaire and focused on post-surgery results.
The newly launched registration system improves on this by collecting more specific information on the operations and asking for details in advance, Nitta said.
Even though registration is on a voluntary basis, the medical bodies expect around 90 percent of facilities will participate in the system, given that many institutions showed willingness to cooperate in response to a questionnaire, according to Nitta.
The two bodies plan a review of cases reported under the new system about once every three months, Nitta said. If they spot any case of serious bleeding or a fatality, they will advise the responsible medical institution.