The Gastroenterology and Endoscopy Center at Kishiwada Tokushukai Hospital has a long-standing tradition of excellence. Over the years, we have expanded our team of physicians and healthcare professionals, and in 2012, we renovated and upgraded our facilities. Since 2008, we have been certified under ISO 9001, reflecting our commitment to high standards and quality assurance recognized both domestically and internationally.

We strive to provide accurate, safe, and comfortable care using the latest equipment and technologies. If you have had a difficult or unsuccessful experience with endoscopy at another hospital, we encourage you to consult with us.

Our center is equipped with 8 endoscopy suites and 2 fluoroscopy rooms, allowing us to offer a wide range of diagnostic and therapeutic procedures — from routine upper and lower GI endoscopy to advanced techniques such as Endoscopic Submucosal Dissection (ESD) for early-stage cancers, one of our specialties. We perform approximately 19,000 endoscopic and fluoroscopic procedures per year.

Our team includes 27 full-time gastroenterologists (including 1 anesthesiologist), 4 part-time physicians, and a support staff of about 50 professionals, including registered nurses, licensed practical nurses, clinical engineers, clerks, and nurse assistants. We perform over 400 ESD procedures annually, averaging 2–3 cases per day, with flexible team roles involving doctors, nurses, and engineers working in cooperation.

We actively welcome outside observers and trainees, and we provide support for live seminars and hands-on training sessions. Our entire team works together to ensure smooth and effective treatment delivery.

At our hospital, we offer colonoscopy performed by female doctors, allowing female patients to undergo examinations with greater comfort and peace of mind.

In the Department of Gastroenterology, we focus on minimally invasive care that reduces the burden on patients. We provide a wide range of services, from routine examinations to advanced therapeutic procedures that require specialized skills.

Our department is committed to comprehensive care using both endoscopy and interventional techniques, always ensuring that patients receive thorough explanations about their condition and treatment options.

We maintain a 24/7 readiness to perform all necessary tests and procedures, including at night, significantly contributing to improved survival rates for time-sensitive conditions.

For early-stage cancers of the esophagus, stomach, and colon, outcomes have greatly improved thanks to the development of Endoscopic Submucosal Dissection (ESD). We perform safe and precise resections using a variety of endoscopic knives — including the IT Knife, Hook Knife, and our own in-house developed Flush Knife.

Because ESD requires both accurate preoperative endoscopic diagnosis and advanced technical skill, it is a highly specialized procedure. Our center has performed over 2,000 ESD cases (as of December 2008). If you’ve been diagnosed elsewhere and are uncertain about your treatment options, we welcome you to consult with us.

We provide diagnosis and treatment for a wide range of gastrointestinal diseases, including:

• Stomach cancer
• Esophageal cancer
• Colorectal cancer
• Gastrointestinal bleeding
• Esophageal and gastric varices
• Common bile duct stones
• Obstructive jaundice
• Bile duct cancer
• Pancreatic cancer
• Liver cancer

If you have been advised to undergo surgery for early-stage esophageal, gastric, or colorectal cancer — or if you have undergone endoscopic treatment for gallstones elsewhere without success — we encourage you to consult with us.

At our Gastroenterology Department, most procedures are performed endoscopically, without the need for open surgery. These minimally invasive treatments allow for faster recovery and reduced physical stress for patients. Below are some of the endoscopic treatments we offer:

Treatment: Endoscopic Submucosal Dissection (ESD)

Conditions Treated: Early-stage stomach, esophageal, and colorectal cancers

Description: ESD is a cutting-edge technique that removes early gastrointestinal cancers without the need for open surgery. It is a minimally invasive procedure that typically requires only a short hospital stay. However, it demands a high level of endoscopic skill and precision.

Treatment: Endoscopic Sphincterotomy (EST)

Conditions Treated: Common bile duct stones, acute cholangitis

Description: This procedure involves the use of an endoscope and an electrosurgical device to make an incision in the papilla of Vater (located in the duodenum) to allow removal of stones from the common bile duct.

Treatment: Endoscopic Hemostasis

Conditions Treated: Bleeding gastric ulcers, diverticular bleeding in the colon, etc.

Description: This emergency procedure uses endoscopic tools such as cautery devices or clips to stop gastrointestinal bleeding.

Upper GI Endoscopy (Gastroscopy)

Gastroscopy is performed with intravenous sedation, allowing patients to undergo the procedure very comfortably. Our center is equipped with the latest endoscopic technology, and all procedures are performed by specialists trained to detect even tiny cancers less than 5 mm in size.

Half of early-stage stomach cancers are found in patients who show no symptoms at all. Stomach cancer is especially common among the Japanese population, so we strongly recommend annual gastroscopy to catch treatable cancer early.

If you’ve had a difficult experience at another facility, please feel free to consult with us. The procedure typically takes 10 to 15 minutes.

Colonoscopy

Just like gastroscopy, regular colonoscopy is now an essential part of preventive care. If your stool test during a health checkup showed blood, or if you’re simply considering having a colonoscopy, please feel free to consult with us — even if you’ve had a difficult experience elsewhere.

Colon cancer often develops from polyps over several years, so undergoing this exam every 2–3 years is usually sufficient. Polyps up to 1 cm in size can often be removed on the spot during the examination, without the need for surgery. We perform this treatment on a same-day, outpatient basis, with no hospital stay required.

Many patients have told us, “It wasn’t uncomfortable at all.” It is also possible to have a gastroscopy and colonoscopy on the same day — just let us know when booking. Female patients who prefer to be examined by a female doctor are also welcome to make this request.

Our Equipment

• 8 endoscopy beds
• 2 fluoroscopy tables

About Our Endoscopy Systems

We perform both diagnostic and therapeutic endoscopy for the upper digestive tract (esophagus, stomach) and lower digestive tract (colon). Our endoscopes are extremely thin — as small as 3 mm in diameter — and inserted through the mouth or anus, depending on the area being examined.

If treatment is required, instruments can be inserted through the tip of the endoscope, allowing us to perform procedures without making any incisions. This results in minimal discomfort and a faster recovery for patients.

Endoscopy Equipment

Our center is equipped with a wide range of cutting-edge endoscopy systems to support a variety of diagnostic and therapeutic procedures across the gastrointestinal tract. Below is an overview of the equipment currently in use:

Upper GI Endoscopes (Esophagus / Stomach)

Olympus:

• GIF-H260×2
• GIF-H260Z×10
• GIF-HQ290×5
• GIF-XZ1200×7
• GIF-1200N×2
• GIF-H290T×3
• GIF-EZ1500×1
• GIF-2TQ260M×1

Fujifilm:

• EG-L600ZW7×5
• EG-L580NW7×8
• EG-L580RD7×1

Duodenoscopes (for ERCP)

Olympus:

• JF-260V×2
• TJF-260V×1
• TJF-Q290V×1

Lower GI Endoscopes (Colonoscopy)

Olympus:

• CF-H260AI×2
• CF-HQ290I×4
• CF-HQ290ZI×3
• CF-XZ1200I×4
• CF-EZ1500DI×1

Pediatric / Slim Colonoscopes:

• PCF-PQ260I×2
• PCF-PQ260L×2
• PCF-H290ZI×5
• PCF-Q260AI×1
• PCF-Q260AZI×1
• PCF-H290TI×2

Fujifilm:

• EC-L600ZP7×8
• EC-L600XP7/L×1
• EC-L600MP7×1

Endoscopic Ultrasound (EUS)

Olympus:

• GF-UCT260×2

Small Bowel Endoscopes

Olympus:

• SIF-Q260I×1
• SIF-H290S×1

Fujifilm:

• EN-450T5/W×1
• EI-530B×1

SpyGlass™ DS Cholangioscopy System

• SpyGlass™ DS System×1 set
  (Used for direct visualization of the bile ducts and pancreatic duct)

What is IBD?

Inflammatory Bowel Disease (IBD) is a group of chronic inflammatory conditions of the digestive tract. The two main types are Ulcerative Colitis (UC) and Crohn’s Disease (CD).

Ulcerative Colitis (UC)

UC causes continuous inflammation of the colon’s inner lining, usually starting in the rectum and sometimes extending to the entire colon. Typical symptoms include diarrhea (often with blood) and abdominal pain. The disease alternates between active flares and remission, and severity ranges from mild to fulminant.

Crohn’s Disease (CD)

CD can affect any part of the digestive tract from mouth to anus, most commonly the terminal ileum and colon. A hallmark is “skip lesions”—inflamed segments separated by normal bowel. Common symptoms include abdominal pain, diarrhea, fever, weight loss, and anal symptoms.

Medical Therapy at Our Hospital

We tailor treatment to each patient’s disease type and activity. Main options include:

• 5-ASA (mesalazine, salazosulfapyridine) — Oral/rectal formulations for induction and maintenance of remission.
• Nutritional therapy — Especially for CD; elemental formulas may replace part of daily intake to reduce relapse risk.
• Corticosteroids — For moderate–severe flares; not for maintenance. Rectal foam preparations are available.
• Thiopurines (e.g., azathioprine) — Steroid-sparing; often combined with biologics. Safety testing (e.g., NUDT15) is performed before starting.
• Anti-TNFα antibodies (infliximab, adalimumab, golimumab) — Effective for UC/CD, including perianal disease; administered on regular maintenance schedules.
• Vedolizumab — Gut-selective anti-integrin biologic with a favorable safety profile.
• Ustekinumab — Anti-IL-12/23 biologic; IV induction followed by subcutaneous maintenance.
• JAK inhibitors (e.g., tofacitinib, filgotinib) — Oral small-molecule therapies that block inflammatory signaling; monitoring is required.

Treatment plans are individualized based on symptoms, history, and coexisting conditions. We also welcome transfer-of-care consultations and second opinions.

Endoscopy & Advanced Tools

When needed, we perform therapeutic endoscopy and ERCP-related procedures. We also utilize the SpyGlass™ DS cholangioscopy system for direct visualization of the bile and pancreatic ducts, enabling targeted biopsy and stone therapy under direct view.

Diagnosis and Treatment