Collaboration and Cooperation
By Osamu Yoshida, M. D., Chairman of 9th Annual International Meeting of SMIT
　The rapid development of a number of new technologies and techniques have led us to seek MIT in multi-disciplinary fields during the last decade. However, this progress has not always been accepted by the general public as a favorable change up to now. We now face a new era when all out collaboration between medical society and industrial companies and more cooperation across all fields of medical science are required to reach satisfactory and successful MIT, not only for patients but also from the socioeconomical contributes. In other words, medical treatment should be less invasive and hopefully minimally invasive, physically and mentally for the patients and socioeconomically for the nations. Hosting this 9th annual International Meeting of the Society of Minimally Invasive Therapy in kyoto is a great pleasure for us. I hope that the meeting will provide all the attendants with the newest technologies and strategies. This is very important for the future of Minimally Invasive Therapy.

Guidelines for Medicine and Health in the 21st Century
By Hiroshi Nakajima, M. D., Director-General of the World Health Organization
　In today's rapidly changing world, some current popular beliefs about human health, suffering, and disability need urgently to be reviewed. For example, infectious diseases can no longer be regarded as a problem only of developing countries. Nor can chronic noncommunicable diseases continue to be seen only as a problem of richer nations. In the 21st century, infectious diseases and chronic diseases will be enemies that have to be fought simultaneously on a global scale. Unlike many infectious diseases , the majority of chronic diseases are preventable but cannot as yet be cured. The emphasis must, therefore, be on preventing their onset, delaying their development in later life, reducing the suffering they cause, and providing a supportive social environment for those disabled by them. The use of less invasive procedure during primary and secondary preventions, which include early detection of diseases and pre-onset diagnosis, offers the potential of improving, in both the short term and the long term, the quality of life. MIT is expected to contribute significantly to reducing the suffering and disability caused by chronic diseases, and this could lead to reducing the social and economic costs for families and society. Research on the genetic determinants of chronic diseases could also provide us with new methods to improve the quality of life. New approaches to ensuring the quality of cares, as well as care for those who cannot be cured, should be developed and improved. Health interventions, including prevention, therapy and care, should be accessible to all.

Interviews with Top Prominent SMIT Researchers
　The meeting was attended by specialists from multisciplinary fields from around the world some of whom were interviewed as to there areas of interest, and future expectations of MIT and SMIT.

Prof. John E. A. Wickham
　John E. A. Wickham, M. S., F. R. C. S. at Guy's University, has seen a gradual shift in membership make-up as well as focus of interest as SMIT President. This year he notes increased interest in vascular and neurosurgery areas and hopes that this will help increase membership of radiologist. This would achieve the original intention of the SMIT for a balanced membership of endoscopic surgeons, radiologists and engineers which is especially important today given the move away from organ-based to technology-based intervention. He sees future MIT being administered by specialists such as endoscopic surgeons, radiologists, bioengineers and others as a team, and the emphasis from in-hospital nursing to domicile care, while surgical training would shift from being anatomy-oriented to one that is endoscopic-oriented. Also MIT must be tailored to help developing countries by converting them into a simple and cheaper form.

Prof. Andrew Adam
　According to Andrew Adam, Professor of Interventional Radiology at Guy's Hospital and SMIT Council President, the society wished to hold the meeting in Japan for a long time as the nation leads the endoscopic field in instruments. Especially in the area of interventional radiology he feels that the X-ray equipments are most innovative. With the MIT field expanding constantly not only due to surgical advantages but also because of patient demand for its cosmetic advantages, low cost and greater comfort, he hopes that this meeting will encourage more Japanese specialists to join SMIT as well as recognize the benefits of this society which is the only multidimensional one of its kind in the world. In ending, he expressed his deep appreciation of Drs. Terachi, Yoshida, and Yamada in their fine coordination of the meeting in Japan.

Prof. Yasuo Idezuki
　Yasuo Idezuki, M. D., President of the Japan Society for Endoscopic Surgery, says that the large number of domestic and international conferences and seminars leaves him with unfortunately little time to keep abreast of developments in other areas of specialization. This situation is aggravated by the fact that they are increasingly less multidimensional in nature. This meeting is therefore most exciting as new approaches and cutting-edge technologies will be well represented. Such knowledge is indispensable as NIT is increasingly offered in Japan and doctors and patients alike must choose the most appropriate course of treatment. Without knowledge, such alternative forms of treatment cannot be selected. Besides which, there is no sidestepping the fact that MIT is the future course of medicine.

Dr. Richard Bihrle
　Dr. Richard Bihrle of Indiana University School of Medicine, whose special area of interest is prostrate BPH, says that although happy with the current function of HIFU to focus ultra-sound energy to a distant site such as the urethra to oblate tissue, he would like to see further improvements so that it can be used as a surgical knife using higher energy. In fact, the IDE will be submitted to the FDA this August opening up new dimensions to its use to treat diseases such as breast fibroadenomas and those of the liver and kidney. As regards the meeting, he has high expectations that he will discover cutting-edge technology in MIT applications which can be applied to the field of urology.

Dr. Ryusaku Yamada
　Dr. Ryusaku Yamada of Osaka City University Medical School, as vice-chairperson of the local committee feels that the biggest task set for them was to achieve as great a representation of MIT in multidisciplinary fields as possible and to encourage Japanese participation. This was largely succeeded with the integration of interventional radiology, endoscopic surgery, interventional cardiology and others, their common denominator being their minimal invasiveness, greater patient comfort, and more rapid recovery. With developments in cutting-edge technologies making rapid progress as seen in imaging diagnosis and others and the advent of increasingly new applications of MIT, he feels that it is vital that information of such breakthroughs be made available to all as they are the forerunners of the dramatic changes that will take place in the medical field when diagnosis and therapy merge to become one.

Dr. Tatsuo Yamakawa
　Dr. Tatsuo Yamakawa of Teikyo University Hospital, who performed the first laparoscopic cholecytectomy in 1990 in Japan, notes that although laparoscopy and endoscopy are gaining ground in Japan due to their clear advantage over conventional surgery in terms of cost and minimal damage to the patient, there are as yet disappointingly few use of MIT in cancer and other operations due to a shortage of specialists. As chairperson of the Educational Committee of JSES, he strongly feels the need to disseminate information to gain the understanding of young doctors in this multidisciplinary therapy and feels that the meeting is most timely as it affords them with an excellent opportunity to gain first-hand information from the many fine minds represented.

Dr. Richard M. Satava
　Richard M. Satava, M. D. of the Defense Advanced Research Project Agency (DARPA) notes that breakthroughs in MIT are occurring not only in one area but in many areas. What is important is that they occur in the three areas of diagnosis, treatment, and educational training for physicians and patients, and this is happening. Advanced imaging technology and 3-D visualization are today, the cornerstone of MIT. They have enabled medical records to be stored in computers as images which can provide a continuous record of the patient's health care from diagnosis to treatment to follow-up. However, these new and advanced technologies are not the final answer - they are but stepping stones, the beginning

Prof. Gerhard F. Buess
　Gerhard F. Buess, Director of Section of MIS at University Clinic Tuebingen states that as the next Council President, he would like to focus more on the question of how modern technology should be incorporated into medicine and how a better cooperation can be achieved in the future between disciplines. This is because important new developments are inter-applicable and increasingly inter-linked. He is also pleased that the meeting is being held in Japan as Japan is one of the leading countries in the field of medical technology and related fields such as robotics and optics and hopes that it will encourage Japanese representation at SMIT meetings and new aspects of technology will be made available to all for discussion.