Gastrointestinal Endoscopy Center

Director and Professor: Kenichi Goda MD, PhD

Characteristics of the section

      We work with doctors, nurses, and nursing assistants from each clinical department related to gastrointestinal endoscopy (gastroenterology, health care center, Hematology and Oncology, Upper gastrointestinal surgery, Liver / gallbladder / pancreatic surgery, Otorhinolaryngology /Head and Neck Surgery) to perform inspections and treatments.
       It has been approved as a training facility of the Japan Gastroenterological Endoscopy Society, the Japan Society for Laser Surgery and Medicine, and the Japanese Association for Capsule Endoscopy.
      We provide advanced endoscopic diagnosis and treatment by instructors and specialists with a full use of advanced equipment.
      In addition, we have created various manuals that enable safe and painless exams for patients and are making efforts every day. 

Activities

     At the Gastrointestinal Endoscopy Center, we actively perform special procedures such as upper and lower gastrointestinal endoscopy, pancreatic and biliary endoscopy, enteroscopy, and capsule endoscopy. We perform about 12,000 inspections and treatments annually. Using the latest equipment and technology, we support a wide range of endoscopic exams and therapy including the latest diagnosis and minimally invasive treatment for patients.

Specific endoscopy and treatment details

1)  Inspections and treatment for gastrointestinal diseases (about 9,000 cases per year)

  • Image-enhanced magnifying endoscopy
          By combining image-enhanced technologies such as NBI and BLI / LCI with magnifying endoscopy, we offer highly accurate diagnosis from the detection of early stage cancer to the tumor extent and the invasion depth.

  • EMR; Endoscopic mucosal resection (about 530 cases a year), ESD; Endoscopic submucosal dissection (about 250 cases a year), ELPS; Endoscopic throat surgery (about 30 cases a year)
          We perform endoscopic resection such as EMR and ESD mainly for early cancer of the esophagus, stomach, duodenum, and large intestine. Recently, the operation of ESD that can reliably remove lesions en bloc has increased tremendously. In addition, we are conducting ELPS for superficial pharyngeal/oral cancer in collaboration with Head and Neck Surgery, and we are working to remove the superficial cancer without a laryngectomy causing aphonia (loss of voice).

  • PDT； Photodynamic therapy (PDT)
         It is an endoscopic treatment that selectively destroys a tumor by irradiating the tumor with a laser after intravenous administration of a tumor-affinitive photosensitizer. For esophageal cancer, it is also indicated for residual or recurrent lesions after chemoradiotherapy.

  • Endoscopic treatment for esophageal varices (about 200 cases per year)
    We have performed a large number of EVL (endoscopic variceal ligation) and EIS (endoscopic injection sclerotherapy) improve the therapeutic effects.

  • Balloon-assisted enteroscopy (about 250 cases a year), Capsule endoscopy (about 150 cases a year)
         We perform balloon-assisted enteroscopy and capsule endoscopy for small intestinal diseases that were once difficult to inspection. With these endoscopic instruments enable it  to diagnose small intestinal bleeding and tumors, and to perform treatments and definitive diagnosis such as hemostasis and biopsy, respectively. It is also possible to diagnosis and treat small intestinal lesions of Crohn's disease.

  • Gastrointestinal stent insertion
         We perform stent insertion mainly for stenosis and perforation cases due to highly advanced cancer that has no possibility of radical cure. We are working to improve QOL by enabling oral intake.

  • Endoscopic ultrasonography and treatment (about 550 cases per year)
         We actively perform endoscopic ultrasonography not only for gastrointestinal tumors of the esophagus, stomach, and large intestine, but also for pancreatic and biliary tract tumors. These inspections can provide close observation of  the tumors and diagnose those extents  and invasions. Furthermore, in recent years, it has become possible to perform reliable histological diagnosis by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), and the operation number of cases performed are increasing rapidly. We also perform endoscopic ultrasonographic pancreatic pseudocyst drainage.

2) Pancreatic / biliary endoscopy and treatment (about 1,000 cases per year)
      We diagnose and treat pancreatic and biliary tract diseases using a side-view endoscope (duodenoscope). We diagnose pancreatic cancer and biliary tract cancer using ERCP techniques, and perform drainage for obstructive jaundice and acute cholangitis. We also remove bile duct stones and place bile duct stents for biliary strictures.

3) Endoscopy and Treatment for Otorhinolaryngology / Head and Neck Surgery (ELPS)
      We perform screening endoscopy for gastroesophageal reflux disease associated with various otolaryngological diseases and pharyngeal cancer that predispose the patients to esophageal squamous cell carcinoma. If superficial pharyngeal/oral cancer is detected, we collaborate with Head and Neck surgeons and can provide minimally invasive per-oral therapy, namely ELPS, for the superficial cancer without a laryngectomy. The patients can maintain the quality of life without loss of voice and normal ingestion.