NTT Medical Center Tokyo performs endoscopic submucosal dissection (ESD) of early gastrointestinal cancer (cancer of the esophagus, stomach, duodenum, and large intestine). Since ESD enables a tumor to be excised without the need for laparotomy, it promises reduced sequela and patient burden, and many patients therefore desire ESD treatment. Increasing numbers of doctors visit us to learn about ESD technology, and in 2018 we performed ESD in 922 cases with a 11-doctor system. We also actively work on ESD for duodenum cancer, which was difficult to treat with endoscopy. Our entire team makes continuous efforts to reduce the ESD treatment time as much as possible. I believe that not only does this reduce the burden on the patient, but it also enables us to treat as many patients as possible in the limited time available to us.

NTT Medical Center Tokyo adopted the "da Vinci" surgical assistance robot in 2016. We mainly use it to treat prostate cancer, of which we treated 112 cases in 2018. Performing surgery with robots promises reduced bleeding and pain after surgery compared to regular surgery, as well as reducing the risk of sequela (such as incontinence and impotence) after surgery. We aim to not only treat cancer with surgery using da Vinci, but also enable patients to return to their normal lives after treatment.

Gamma knife treatment is a type of radiotherapy that exposes the brain tumor or vascular malformation to focused radiation (gamma rays) controlled by a computer, without the need for craniotomy. Conventional craniotomy surgery places a great physical burden on the patient and is unable to treat some areas, but gamma knife treatment overcomes such problems and makes treatment possible. Metastatic brain tumors, which are said to affect 10% of cancer patients, dramatically decrease the patient's quality of life by causing convulsions, paralysis, and problems with memory and emotions. Although treating metastatic brain tumors does not necessarily lead to complete recovery, I believe that it is very important from the perspective of enabling patients to enjoy their remaining time as much as possible.

Radiofrequency ablation (RFA) is a method for treating liver cancer by inserting an electrode into the abdomen and using the heat of high-frequency radio waves to coagulate/necrotize the lesion, without the need for laparotomy.NTT Medical Center Tokyo adopted RFA in 2006, and it was used in 355 cases in 2018. In cases where RFA treatment is normally thought to be difficult, if the patient is determined to have no other treatment options, we will perform it RFA with the consent of the patient and strive to improve the prognosis. We also spare no effort to enable swift patient acceptance.

The treatment of cerebral strokes in the acute stage now often involves medical treatment first, but if that treatment is insufficient, we must also consider switching to surgical treatment. That is why close cooperation between the cerebrovascular medicine and neurosurgery divisions is very important for treating strokes. At NTT Medical Center Tokyo, neurosurgeons are always on standby to provide surgery for patients that require it. We also focus on treatment for preventing strokes in addition to acute stage treatment, and we proactively perform cerebral aneurysm clipping of unruptured cerebral aneurysms using a microscope. Our neurosurgery division performed 289 cases of surgery in 2018 (including brain tumor surgery), and provide daily medical care while being constantly aware of how past experience can be utilized for all of our patients.

We handle more than 1,000 annual cases of emergency treatment for cardiovascular diseases such as angina pectoris, cardiac infarction, arrhythmia, valvular disease, and heart failure. In particular, ischemic heart diseases such as cardiac infarction often require emergency treatment. We have a 24-hour emergency support system to provide emergency catheter treatment anytime, even at night or on holidays, and also link with the cardiovascular surgery division to swiftly provide emergency surgery when required. We share the status of all our patients amongst all staff on a daily basis, and this enables us to swiftly handle unforeseen situations, even if the doctor in charge happens to be away. We also strive to enhance regional medical care by creating a network with local doctors, etc., to ensure that patients can smoothly receive care after they are discharged.