TOPICS Current status and future of laparoscopic liver resection Status of endoscopic liver surgery in Japan: a questionnaire survey conducted by the Japanese Endoscopic Liver Surgery Study Group Masaru Tsuchiya Æ Yuichiro Otsuka Æ Akira Tamura Æ Hiroyuki Nitta Æ Akira Sasaki Æ Go Wakabayashi Æ Hironori Kaneko Received: 1 March 2009 / Accepted: 31 March 2009 / Published online: 21 May 2009 Ó Springer 2009 Abstract Background/purpose In 2007, the First Annual Meeting of the Japanese Endoscopic Liver Surgery Study Group was convened. We report the results of a questionnaire survey conducted by this study group that attempted to assess the current status and safety of endoscopic liver surgery. Methods A questionnaire survey was conducted at 26 hospitals to determine the operative procedures, rates of conversion to open surgery, and morbidity rates in patients who had undergone laparoscopic hepatectomy and endo- scopic ablation therapy. Results Laparoscopic hepatectomy was performed in 471 patients by means of nonanatomical partial resection (57.7%), left lateral sectionectomy (24.6%), hemihepatec- tomy (12.5%), sectionectomy other than lateral sectionec- tomy (2.5%), and segmentectomy (2.5%). Hepatectomy was performed by a totally laparoscopic procedure in 47% of the patients and by a hybrid procedure in 53%. The rate of complications was 12.3%; there was no case of serious liver failure or operative mortality. Endoscopic ablation therapy was performed in 169 patients through a thoraco- scopic (25.4%) or laparoscopic approach (74.6%), using radiowaves (55.6%), microwaves (40.2%), cryotherapy (1.8%), or ethanol (0.6%). The incidence of complications was 6.6%. Conclusions In properly selected patients, laparoscopic hepatectomy and endoscopic ablation therapy are safe treatments for liver tumors. Keywords Endoscopic liver surgery Á Laparoscopic hepatectomy Á Endoscopic ablation therapy Á Minimally invasive liver surgery Á Hepatic tumor Introduction Laparoscopic hepatectomy (LH) for benign liver tumors was first described by Reich et al. in 1991 [1] and is now widely used to treat primary and metastatic malignant tumors. Initially, because of difficulties in technique and control of bleeding, LH was not widely accepted and was performed only at a limited number of hospitals. More recently, however, LH has been reported to be equivalent to open surgery with respect to survival, and is less inva- sive [2–4]. These findings led to further development of surgical techniques and devices and to increasing interest in LH. The First Annual Meeting of the Japanese Endo- scopic Liver Surgery Study Group was held in November 2007 (Chairman, H. Kaneko). We report the results of a questionnaire survey conducted by this study group, which attempted to assess the safety and current status of endo- scopic liver surgery in Japan. Subjects and results A questionnaire survey was conducted at 26 member hospitals of the Japanese Endoscopic Liver Surgery Study Group to assess the types of operative procedures, rates of conversion to open surgery, and morbidity rates [bile M. Tsuchiya Á Y. Otsuka Á A. Tamura Á H. Kaneko (&) Division of General and Gastroenterological Surgery, Department of Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan e-mail: hironori@med.toho-u.ac.jp H. Nitta Á A. Sasaki Á G. Wakabayashi Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan 123 J Hepatobiliary Pancreat Surg (2009) 16:405–409 DOI 10.1007/s00534-009-0119-1