Gastrointestinal Endoscopy

(1) Overview

We perform endoscopic examinations and treatments for a wide range of gastrointestinal disorders. We actively perform endoscopic submucosal dissection (ESD), a procedure in which the cancerous area is dissected down to the submucosal layer using an endoscope and the lesion is removed in one piece, for early-stage cancers of the esophagus, stomach, duodenum, and colon. In particular, for ESD procedures for duodenal cancer, patients come to us not only from the Kanto region but also from more distant areas.
As of February 2025, our endoscopy suite consists of 12 rooms: seven for general outpatient care (located on the first floor) and five dedicated to comprehensive health checkups (on the third floor of the Healthcare Building). We continually update our endoscopic equipment to ensure the use of the latest technology.

(2) Policy

Highly Accurate Endoscopic Tests and Treatment with Minimal Discomfort

Cancer, which is one of the primary conditions targeted by endoscopic examinations, is a disease that must be detected without being overlooked. We strive to perform highly accurate endoscopic examinations to ensure that no early-stage cancer goes undetected.
We also prioritize patients comfort by offering sedation upon request during endoscopic procedures.

(3) Our Strengths

Extensive Experience in Endoscopic Treatment

We have performed a large number of ESD procedures for the esophagus, stomach, duodenum, and colon. In 2024 (January – December), we performed 18,216 upper endoscopies and 9,649 lower endoscopies.

24/7 Emergency Support

We provide round-the-clock emergency services for conditions such as sudden hematemesis and melena. We also ensure comprehensive post-procedure care, especially in cases of complications like bleeding.

Global Training Hub

Many physicians who aspire to “a master level endoscopic skills” come from around the world to observe and train. At any given time, approximately 10 international physicians are engaged in training with us.

Same-day Colorectal ESD

We perform over 1,000 ESD procedures for gastrointestinal cancers annually, making it a central part of our clinical practice.
In particular, we have accumulated extensive experience in colorectal ESD.
While this procedure typically requires a hospital stay of about one week, our expertise and technical proficiency allow us to offer same-day treatment for selected patients based on their condition.

Transnasal Endoscopy

We perform ESD for early-stage gastric cancer using a transnasal endoscope (inserted through the nose).
Typically, ESD for early gastric cancer is performed using a transoral endoscope (inserted through the mouth) under sedation. However, in elderly patients, sedation can increase the risk of complications due to the physical stress it imposes.
In contrast, transnasal ESD generally does not require sedation with anesthetic drugs, making it a safer option for elderly patients.
We have established a system that allows elderly patients to undergo ESD treatment more safely. As a result, many patients who had previously given up on treatment due to their age now travel from distant regions to receive care at our hospital.

Comprehensive Evaluation and the Latest Treatments for GERD

We provide comprehensive diagnosis and treatment for gastroesophageal reflux disease (GERD), including reflux esophagitis. To objectively assess symptoms such as unexplained heartburn or discomfort in the throat, we perform 24-hour pH monitoring.
For patients whose symptoms do not improve with medication or who are unable to continue pharmacological therapy, we offer the following endoscopic treatments:

• ARMP (Anti-Reflux Mucoplasty): Dissects the mucosa and reshapes the gastroesophageal junction to prevent gastric acid reflux.
• ARMA (Anti-Reflux Mucosal Ablation): Uses mucosal ablation to reduce gastric acid reflux.

These treatments are minimally invasive, promote faster recovery, and contribute to improving patients’ quality of life (QOL).

Treatment for Esophageal Achalasia

Esophageal achalasia is a condition in which the junction between the esophagus and stomach fails to relax, hindering food passage.
We offer esophageal manometry for diagnosis and POEM (Per-Oral Endoscopic Myotomy) as a treatment.
POEM is a procedure that uses an endoscope to cut the muscles at the lower end of the esophagus, helping to relieve symptoms. It offers outcomes comparable to traditional surgery with reduced physical burden and lower complication risk.

Sedation Options for Patient Comfort

We actively use anesthetics (sedatives) upon patient requests during endoscopic examinations and treatments. Our endoscopy room is staffed by board-certified anesthesiologists who oversee sedation and anesthesia management.
Sedation, especially with Propofol, which is an intravenous anesthetic, should be conducted independently by specialists. To prioritize patient safety, our hospital has established a collaborative system with the Department of Anesthesiology to ensure that procedures are performed safely and effectively.
According to the Handbook of Gastrointestinal Endoscopy (3rd Revised Edition) published by the Japan Gastroenterological Endoscopy Society, it is clearly stated that:
“When using propofol for sedation, a physician proficient in anesthesia techniques must be assigned exclusively to manage sedation, separate from the endoscopist performing the procedure.”

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Message for Our Patients

If you are currently receiving care at another hospital or clinic, please bring a referral letter. This helps us understand your condition more accurately, avoid unnecessary tests, and reduce the number of outpatient visits.
Although outpatient visits are by appointment, we also accept walk-in patients as long as they bring a referral letter. If you come without an appointment, the waiting time may be longer.
However, please rest assured that you will definitely be seen on that day. There is no need to spend anxious days until your scheduled appointment.
We receive patients from all over Japan. Some may worry that it takes a long time from the initial consultation to the start of treatment. However, there is no need for concern. Endoscopic examinations can typically be scheduled within a few days, and hospitalization for cancer treatment is generally arranged for the following week.
Because we serve a large number of patients, we have established a system that allows us to respond efficiently and promptly. Please rest assured that you will receive timely care.