Laparoscopy & Hysteroscopy in China

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Roberta Speyer: Hello, it’s Roberta Speyer reporting for OBGYN.net. I am here with Dr Leng and Dr Xia and we are going to talk about laparoscopy and hysteroscopy in Beijing at the Peking Union Medical Hospital College. Did I say that right this time?

Dr Leng: Peking Union Medical College Hospital.

Roberta Speyer: I am getting closer. Yes, and you are a hysteroscopist and you are a laparoscopist and you are both very busy, but first I would like to talk to Dr Xia, who is also very famous as one of the pioneers in hysteroscopy. Could you tell us a little bit about the early days when you introduced hysteroscopy into China?

Dr Xia: Yes, first it was in 1990, it was me, I introduced the hysteroscopy technique in China and I practiced it in my centre, a centre named Hysteroscopy Centre, Fuxing Hospital, affiliated with the Medical College of Capitol University. Since then, we performed more than 30,000.

Roberta Speyer: 30,000. That is a lot.

Dr Xia: 30,000 diagnostic hysteroscopy.

Roberta Speyer: That is a lot of hysteroscopy.

Dr Xia: Okay, and more than 6,000 hysteroscopy surgeries in my centre and I have held 14 hysteroscopic and laparoscopic workshops in my centre. A lot of doctors practice and learn this skill in the workshop.

Roberta Speyer: And then they take it out into the hospitals or across China? And then they teach their colleagues?

Dr Xia: Yes, more than 2,000 doctors practice their hysteroscopy and laparoscopy skills in my centre and when they come back, they can use this new technique to treat and diagnose women’s disease. It is very useful and a minimally invasive technique. It is quite better than the traditional method.

Roberta Speyer: It is really a beautiful surgery and diagnosis that you can perform. We have on OBGYN.net a very strong tie to the AAGL and the ISGE and you also have a group in China. Tell us a little bit about this.

Dr Xia: Since 2000, the Chinese Gynecological Endoscopy Group affiliated with the CME, which is the CMA’s Chinese medical association, has been held since 2000 and that is a maelstrom of gynecological endoscopy in China.

Roberta Speyer: How big is the membership?

Dr Xia: There are 110,000 gynecologist working in China and among them, 20,000 gynecologists are in gynecological endoscopy and use hysteroscopy to treat and diagnose their work. That is a lot of tea in China, I think.

Roberta Speyer: Is laparoscopy, Doctor, really on the rise here because there is a plateau in the United States almost. We have about 35,000 to 38,000 OB/GYNs and the active membership in AAGL is about 6,000, maybe. You look at the whole group, it is 10,000 but it is not really moving. Are you finding it growing or are you finding this similar kind of plateau?

Dr Leng: Yes, in China I mean, the number of doctors who are involved in gynecology and endoscopy, whatever, laparoscopy, the number is increased gradually. As you know, as early as the 1970s, laparoscopy was first introduced in China in our hospital by Dr John Phillips.

Roberta Speyer: A very good friend of OBGYN.net.

Dr Leng: Yes, our old friend, you mean pioneer and Dr (inaudible) who is our teacher and also the pioneer of laparoscopy in China. So since then, the technique of laparoscopy was introduced in the whole of China gradually, so we have workshops, we have congress, and something like that, about the technique of laparoscopy and also of hysteroscopy. Now, I mean, in the last 20 years in China, about 50% of gynecologists can do laparoscopic surgery.

Roberta Speyer: Really?

Dr Leng: Yes, 50%. By now, in the major hospitals in the big cities, all the teaching hospitals in the college hospitals, the proportion of the benign gynecologic disease can be managed laparoscopically about 60% to 70%, so laparoscopy is becoming a major central technical event. So now the element of laparoscopic technique becomes more recognized and more standardized. Since the development in that regimen of Chinese gynecologic and endoscopic group in 2000, we have the annual meeting.

Roberta Speyer: In May of this year.

Dr Leng: Yes, this is the third congress, yes. Every two years, we have the nationwide congress about gynecology and endoscopy and also we have another original meeting in every part of China because, as you know, China is very big.

Roberta Speyer: You have a lot of local meetings.

Dr Leng: A lot of local meetings. So in this local meeting, meaning at our membership board, our membership go there and give lectures and also give, not demonstrations, demonstrations.

Roberta Speyer: This is so important with the technique.

Dr Leng: Yes, yes.

Dr Xia: Yes, yes.

Roberta Speyer: To do the hands-on training. Have you been able to do any tele-medicine at all? Have you done any surgeries that you have been able to broadcast or any of that type of work as the AAGL does at their meetings? They always have a tele-surgery.

Dr Leng: In China no, we only do surgery in some cities, so in the future, maybe we do the television. It would be good. In our future, but now we are not doing that. We can transmit video from Hong Kong to Beijing, it is the only one, but mostly we just do in the same city.

Roberta Speyer: This is what we are hoping with our affiliation with the AAGL to bring more of the surgery and the CME and the training, not because, you do have to be there and train, it is a hands-on thing, but to bring it to people to at least make them aware and once they watch it on-line, on a China OBGYN.net, and they see the possibilities, then to be able to set up a workshop locally, that is where the challenge lies, don’t you agree?

Dr Leng: Yes, it is. While the people of this Chinese OBGYN.net is a bridge of this side which can promote this new technique faster and safer and repetitively because if a doctor from this city to another city, another can see the physician and know the cost, so if you have the website training, the website communication, this technique can be more than the training, this technology can become more convenient, I think.

Roberta Speyer: As new trainers, I saw Dr Hasson, a past president of AAGL, has created a trainer that you can practice. Very interesting stuff. Well, we are excited to keep an eye on it. I personally have always been a strong supporter of laparoscopic surgery. I had it myself and I was out driving and back at work in a week and it really is much better for the patients and the awareness of that recovery time, the cost and the savings and the health, is a wonderful thing. I applaud both of you for what you are doing. I appreciate your taking the time to talk to us. Thank you very much.

Dr Leng: Thank you.

Dr Xia: Thank you.