Hospitals resume gastric cancer surgery after brief suspension

Hospitals nationwide will resume performing a common operation for early-stage gastric cancer after the potentially life-saving surgery was suspended for a week because of a financial dispute between the Ministry of Health and Welfare and the importer of a critical surgical tool used in the operations.

The dispute arose after the ministry on Sept. 1 adopted new national health insurance guidelines, setting the price of a special surgical knife required for the operations at 95,000 won ($85), lower than the instrument’s imported cost.

The operation is called endoscopic submucosal dissection, in which an endoscope is used to remove early-stage cancer in the esophagus, stomach and colon. ESD is the preferred treatment method for early-stage cancerous tumors measuring less than two centimeters (0.79 inches) found in the gastric system.

Olympus Korea, which controls 75 percent of the market share for ESD knives, halted shipments of the critical tool after the ministry’s decision. It also had knives already distributed to hospitals returned, forcing most major medical institutions across the country, including Asan Medical Center and Yonsei University Severance Hospital, to suspend ESD operations.

Only a few hospitals, including Samsung Medical Center and Seoul National University Bundang Hospital, were able to continue performing ESD because they refused to return their supplies of knives.

About 6,000 ESD operations are conducted annually in the country.

In the face of public criticism, however, the ministry convened a meeting on Sept. 9 with health officials and agreed to resume ESD operations starting last Wednesday by raising the insurance fee of the surgery while expanding the scope of ESD surgery.

The ministry had previously only allowed tumors of less than two centimeters to be removed using ESD surgery, but after bring criticized for being too restrictive, the ministry said it would consider expanding the size of tumors eligible to be removed with ESD to three centimeters.

Olympus Korea, after the ministry’s latest announcement, said it would resume supplying ESD knives and deal with the price adjustment afterward with the government.

Before the ministry’s decision to resume the operations, the importer had said that the ministry’s price guidelines for the ESD knives were way below their imported costs.

The imported cost of the most widely used ESD knife is 130,000 won, and the price charged to hospitals is about 400,000 won, according to Olympus Korea.

By Yim Seung-hye [sharon@joongang.co.kr]