Da Vinci Surgical System

Laparoscopic surgery, known for being a “body-friendly surgery” (minimally invasive surgery) that can be performed with small incisions, has become the standard treatment in Japan. In recent years, surgical assist robots have been introduced and are becoming increasingly widespread. Laparoscopic surgery was first introduced in the surgical field in the 1990s, and its usefulness has been confirmed. To further enhance laparoscopic surgery, surgical assist robots were developed.

The surgical assist robot “Da Vinci” was developed in the United States starting in the 1980s, completed in 1999, and has been used as a surgical assist device since 2000. In robot-assisted surgery, the three-dimensional endoscopic view provides detailed information about the interior of the abdomen. Additionally, the robotic instruments can accurately replicate the delicate movements of the surgeon’s hands, enabling surgeries that are even less invasive and safer than traditional laparoscopic surgery. Robot-assisted surgery is particularly effective for complex pelvic surgeries, such as ultra-low anterior resection, intersphincteric resection, and lateral lymph node dissection for rectal cancer.

4th Generation Da Vinci Xi

In 2021, our hospital installed the 4th generation Da Vinci Xi surgical assist robot. Since then, under the guidance of surgeons certified by the Japan Society for Endoscopic Surgery, we have actively implemented robot-assisted surgeries for rectal and colon cancers.

We will continue to actively introduce robot-assisted surgeries with the goal of promoting minimally invasive surgery and further improving our techniques through close collaboration among doctors, nurses, and clinical engineers. We will advance staff training and clinical research.

Laparoscopic Surgery Overview

Laparoscopic surgery offers several advantages, including smaller incisions, minimal invasiveness, and the ability to perform precise operations thanks to its enhanced magnification.

In our department, under the guidance of surgeons certified by the Japan Society for Endoscopic Surgery, we perform laparoscopic surgery not only for colorectal cancer but also for benign conditions such as rectal prolapse, acute appendicitis, and generalized peritonitis caused by perforated diverticulitis.

For colorectal cancer diagnosed as unresectable, we implement systemic chemotherapy based on the Colorectal Cancer Treatment Guidelines, with the goal of improving patient survival outcomes. In some cases, even if the cancer is initially deemed unresectable, chemotherapy can be effective in shrinking the tumor, potentially making curative surgery possible.

When introducing systemic chemotherapy, we work closely with our palliative care team to ensure that care is provided with consideration for the patient’s quality of life (QOL).

Sacral Nerve Stimulation Therapy

In recent years, functional disorders related to bowel and bladder control have become significant concerns. It is estimated that around 5 million people in Japan suffer from fecal incontinence.
While these conditions are more common among the elderly, they can also affect patients who have undergone rectal or prostate surgery, often leading to a substantial decline in their quality of life (QOL).

Our department provides comprehensive diagnosis and specialized treatment for conditions such as fecal incontinence, constipation, and pelvic organ prolapse (including rectal prolapse) that result from dysfunctions of the rectum, bladder, uterus, and the muscle groups at the pelvic floor (such as the levator ani and anal sphincter muscles). When conservative treatments, like medication, fail to improve fecal incontinence or rectal prolapse, surgical intervention may be recommended.

One of the surgical treatments available for fecal incontinence is Sacral Nerve Stimulation (SNS). This therapy is recommended as an effective treatment in the “Guidelines for the Treatment of Fecal Incontinence,” published in 2017. The procedure involves temporary stimulation for about two weeks, and if effective, a permanent stimulator is implanted under the skin of the lower back. Approximately 70% of patients experience improvement in fecal incontinence with this therapy.

For rectal prolapse, surgical options include transanal and transabdominal procedures, with the surgical approach chosen based on the severity of the prolapse. In cases where a less invasive treatment is desired, we perform laparoscopic rectopexy, a surgery that lifts and secures the rectum inside the abdomen.