{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:38:16Z","timestamp":1792820296435,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":183,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23K16812"],"award-info":[{"award-number":["JP23K16812"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007312","name":"National Center for Geriatrics and Gerontology","doi-asserted-by":"publisher","award":["24\u20101"],"award-info":[{"award-number":["24\u20101"]}],"id":[{"id":"10.13039\/501100007312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Robot\u2010assisted laparoscopic resection for malignant colon tumors was newly reimbursed in Japan in April 2022, but early national billing\u2010based uptake and geographic variation after reimbursement have not been described using public aggregate claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed the ninth and tenth National Database Open Data releases for fiscal years 2022 and 2023. Using inpatient K\u2010surgery tables by treating\u2010institution prefecture, we calculated the robot\u2010assisted proportion as robot\u2010assisted malignant colon tumor resection billing counts divided by the sum of conventional and robot\u2010assisted laparoscopic malignant colon tumor resection billing counts. National proportions were calculated from suppression\u2010free total columns. Prefecture\u2010level summaries were reported among displayed prefectures, with a bounded small\u2010cell sensitivity assessment for masked robot\u2010assisted cells.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      National robot\u2010assisted billing counts increased from 1652 to 6141, and the total\u2010based national proportion rose from 3.38% to 11.42%. The number of prefectures with displayed robot\u2010assisted numerator cells increased from 36 to 43. The displayed\u2010prefecture median increased from 1.72% to 8.63%. In a bounded small\u2010cell sensitivity analysis constrained to the hidden national\u2010total difference, the possible fiscal year 2022 median was 0.90%\u20131.83%, and the fiscal year 2023 median was 8.45%. Among 33 prefectures with displayed data in both years, the median proportion rose from 1.89% to 9.65%, with a median within\u2010prefecture change of +6.76 percentage points; 30 prefectures increased, one decreased, and two were unchanged. Under a direction\u2010of\u2010change sensitivity classification incorporating masked transitions, 43 prefectures were classifiable as increased, one decreased, two were unchanged, and one remained indeterminate. Fiscal year 2023 variation remained substantial among displayed prefectures, with values ranging from 0.00% to 27.79%, and paired ranks were moderately stable (Spearman\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.77).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robot\u2010assisted billing among laparoscopic malignant colon tumor resection codes increased rapidly from the first to the second reimbursement year, but inter\u2010prefectural variation remained.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70343","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T02:29:38Z","timestamp":1783132178000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Diffusion and Regional Variation in Robot\u2010Assisted Laparoscopic Resection for Malignant Colon Tumors in Japan: An Analysis of National Database Open Data From Fiscal Years 2022 and 2023"],"prefix":"10.1111","volume":"19","author":[{"given":"Tomomi","family":"Omura","sequence":"first","affiliation":[{"name":"Department of Geriatric and General Internal Medicine Meitetsu Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4592-4170","authenticated-orcid":false,"given":"Takahiro","family":"Kamihara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital, National Center for Geriatrics and Gerontology  Obu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5490-8653","authenticated-orcid":false,"given":"Takuya","family":"Omura","sequence":"additional","affiliation":[{"name":"Department of Metabolic Research Research Institute, National Center for Geriatrics and Gerontology  Obu Japan"},{"name":"Department of Diabetes and Endocrinology Hospital, National Center for Geriatrics and Gerontology  Obu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12579"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12694"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16081552"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.70007"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.70220"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120\u2010024\u201001553\u2010y"},{"key":"e_1_2_12_8_1","volume-title":"Medical Fee Schedule Master Revision Materials for FY2022","author":"Health Insurance Claims Review & Reimbursement Services","year":"2022"},{"key":"e_1_2_12_9_1","volume-title":"The 9th NDB Open Data","author":"Ministry of Health, Labour and Welfare, Japan","year":"2024"},{"key":"e_1_2_12_10_1","volume-title":"The 10th NDB Open Data","author":"Ministry of Health, Labour and Welfare, Japan","year":"2025"},{"key":"e_1_2_12_11_1","volume-title":"The 9th NDB Open Data Explanatory Materials","author":"Ministry of Health, Labour and Welfare, Japan","year":"2024"},{"key":"e_1_2_12_12_1","volume-title":"The 10th NDB Open Data Explanatory Materials","author":"Ministry of Health, Labour and Welfare, Japan","year":"2025"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.2.1_13"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12865"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010023\u201006820\u20100"}],"container-title":["Asian Journal of Endoscopic 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