{"id":417,"date":"2026-01-09T06:13:41","date_gmt":"2026-01-09T06:13:41","guid":{"rendered":"https:\/\/kishiwada.tokushukai.or.jp\/en\/?page_id=417"},"modified":"2026-04-11T03:56:07","modified_gmt":"2026-04-11T03:56:07","slug":"lower-gi-surgery","status":"publish","type":"page","link":"https:\/\/kishiwada.tokushukai.or.jp\/en\/departments\/lower-gi-surgery\/","title":{"rendered":"Lower GI Surgery"},"content":{"rendered":"<p><!-- ============================================================\n     Lower GI Surgery (Colorectal & Rectal Surgery)\n     URL: \/en\/departments\/lower-gi-surgery\/\n     Target: A (overseas) + B (resident foreigners)\n     Focus Keyword: colorectal\n     Last updated: 2026\n     ============================================================ --><\/p>\n<p class=\"hero-sub\">Colorectal and rectal surgery in Japan \u2014 sphincter preservation, da Vinci robotic surgery, and pelvic functional care. No waiting lists.<\/p>\n<p><!-- \u2500\u2500 Why Patients Come Here \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section\">\n<div class=\"dept-when\">\n<div class=\"dept-when__block\">\n<h3 class=\"dept-when__title\">Why international patients choose us<\/h3>\n<ul class=\"dept-when__list\">\n<li><strong>Sphincter-preserving surgery<\/strong> for rectal cancer \u2014 avoiding permanent colostomy where clinically appropriate<\/li>\n<li><strong>da Vinci robotic surgery<\/strong> for colorectal cancer \u2014 precision and minimally invasive treatment<\/li>\n<li><strong>Pelvic functional surgery<\/strong> for fecal incontinence and rectal prolapse<\/li>\n<li>Systemic chemotherapy for unresectable colorectal cancer, with potential conversion to surgery<\/li>\n<li><strong>No waiting lists<\/strong> \u2014 treatment planning begins promptly after assessment<\/li>\n<\/ul>\n<p class=\"dept-when__note\">Full outcome data: <a href=\"\/en\/research\/publications\/lower-gastrointestinal-surgery\/\">Dr. Tokuhara&#8217;s profile and publications \u2192<\/a><\/p>\n<\/p><\/div>\n<div class=\"dept-when__block dept-when__block--er\">\n<h3 class=\"dept-when__title\">Surgeon&#8217;s experience<\/h3>\n<ul class=\"dept-when__list\">\n<li><strong>Approximately 1,400 operations<\/strong> as primary surgeon<\/li>\n<li>Specialist in robot-assisted and laparoscopic colorectal surgery<\/li>\n<li>Publications in <em>Colorectal Disease<\/em>, <em>Surgical Endoscopy<\/em>, and other peer-reviewed journals<\/li>\n<li>Treatment planning emphasises both curability and quality of life<\/li>\n<\/ul>\n<p class=\"dept-when__note\">20 minutes from Kansai International Airport (KIX)<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n<p><!-- \u2500\u2500 About Us \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section\">\n<h2>About Us<\/h2>\n<p>\n    Colorectal surgical care at Kishiwada Tokushukai Hospital is provided by<br \/>\n    <strong>Katsuji Tokuhara, M.D., Ph.D.<\/strong>, specialising in colorectal and rectal cancer.\n  <\/p>\n<p>\n    Treatment is planned with consideration of both <strong>curability<\/strong> and <strong>quality of life<\/strong>.<br \/>\n    Minimally invasive techniques \u2014 including <strong>robot-assisted (da Vinci)<\/strong> and<br \/>\n    <strong>laparoscopic surgery<\/strong> \u2014 are used where appropriate.<br \/>\n    Multimodal treatment combining surgery, chemotherapy, and radiation therapy is provided when indicated.\n  <\/p>\n<p>\n    For patients with <strong>unresectable colorectal cancer<\/strong>, systemic chemotherapy is introduced<br \/>\n    based on established clinical guidelines. In selected cases, tumour response may allow<br \/>\n    <strong>subsequent curative surgery<\/strong>.\n  <\/p>\n<p>\n    In addition to cancer care, we provide specialist treatment for<br \/>\n    <strong>fecal incontinence<\/strong> and <strong>rectal prolapse<\/strong>,<br \/>\n    conditions that significantly affect daily life and may be improved with surgical management.\n  <\/p>\n<\/section>\n<p><!-- \u2500\u2500 Clinical Leadership \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section dept-leadership\">\n<h2>Clinical Leadership<\/h2>\n<p>\n    Colorectal surgical care is led by <strong>Katsuji Tokuhara, M.D., Ph.D.<\/strong>,<br \/>\n    Chief of Colorectal Surgery and Director of the Regional Medical Cooperation Center.\n  <\/p>\n<p>\n    He specialises in <strong>robot-assisted<\/strong> and <strong>laparoscopic surgery<\/strong> for colorectal cancer<br \/>\n    and has performed approximately <strong>1,400 operations<\/strong> as primary surgeon.<br \/>\n    Treatment planning emphasises both curability and quality of life, with multidisciplinary collaboration as needed.\n  <\/p>\n<p><a href=\"\/en\/research\/publications\/lower-gastrointestinal-surgery\/\">Full profile and publications \u2192<\/a><\/p>\n<\/section>\n<p><!-- \u2500\u2500 Services \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section\">\n<h2>Services<\/h2>\n<div class=\"dept-scope\">\n<div class=\"dept-scope-item\">\n      <a href=\"\/en\/departments\/lower-gi-surgery\/da-vinci\/\" class=\"dept-scope-link\">Robot-assisted surgery (da Vinci)<\/a>\n    <\/div>\n<div class=\"dept-scope-item\">\n      <a href=\"\/en\/departments\/lower-gi-surgery\/laparoscopic-surgery\/\" class=\"dept-scope-link\">Laparoscopic surgery<\/a>\n    <\/div>\n<div class=\"dept-scope-item\">\n      <a href=\"\/en\/departments\/lower-gi-surgery\/systemic-chemotherapy-colorectal-cancer\/\" class=\"dept-scope-link\">Systemic chemotherapy for unresectable colorectal cancer<\/a>\n    <\/div>\n<div class=\"dept-scope-item\">\n      <a href=\"\/en\/departments\/lower-gi-surgery\/pelvic-functional-surgery\/\" class=\"dept-scope-link\">Pelvic functional surgery (fecal incontinence \/ rectal prolapse)<\/a>\n    <\/div>\n<\/p><\/div>\n<div class=\"dept-services-note\">\n    Appointments are recommended. A referral from another medical institution is helpful.<br \/>\n    Emergency cases are accepted through the Emergency Department.\n  <\/div>\n<\/section>\n<p><!-- \u2500\u2500 Key Procedures \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section\">\n<h2>Key Procedures<\/h2>\n<div class=\"ofv-row\">\n<div class=\"ofv-label\">Sphincter-preserving surgery<\/div>\n<div class=\"ofv-body\">\n      For rectal cancer, we aim to preserve the anal sphincter and avoid permanent colostomy<br \/>\n      where clinically appropriate. Robot-assisted surgery enables precise dissection<br \/>\n      in the narrow pelvic space.\n    <\/div>\n<\/p><\/div>\n<div class=\"ofv-row\">\n<div class=\"ofv-label\">da Vinci robotic surgery<\/div>\n<div class=\"ofv-body\">\n      Used for colectomy, rectal resection, and pelvic surgery.<br \/>\n      Robot-assisted techniques provide enhanced visualisation and instrument control,<br \/>\n      particularly beneficial for low rectal cancer.\n    <\/div>\n<\/p><\/div>\n<div class=\"ofv-row\">\n<div class=\"ofv-label\">Laparoscopic colorectal surgery<\/div>\n<div class=\"ofv-body\">\n      Minimally invasive resection for colon and rectal cancer,<br \/>\n      including standard colorectal procedures.<br \/>\n      Smaller incisions and reduced recovery time compared to open surgery.\n    <\/div>\n<\/p><\/div>\n<div class=\"ofv-row\">\n<div class=\"ofv-label\">Pelvic functional surgery<\/div>\n<div class=\"ofv-body\">\n      Surgical treatment for fecal incontinence and rectal prolapse,<br \/>\n      with evaluation of pelvic floor function and tailored operative planning.\n    <\/div>\n<\/p><\/div>\n<div class=\"ofv-row\">\n<div class=\"ofv-label\">Systemic chemotherapy<\/div>\n<div class=\"ofv-body\">\n      For unresectable colorectal cancer, chemotherapy is introduced based on current guidelines.<br \/>\n      In selected cases, tumour response allows conversion to surgical treatment.\n    <\/div>\n<\/p><\/div>\n<div class=\"ofv-row\">\n<div class=\"ofv-label\">Lateral pelvic lymph node dissection<\/div>\n<div class=\"ofv-body\">\n      For advanced low rectal cancer, performed laparoscopically or robot-assisted<br \/>\n      to reduce local recurrence risk.\n    <\/div>\n<\/p><\/div>\n<\/section>\n<p><!-- \u2500\u2500 When to Visit \/ ER \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section\">\n<h2>When to Visit \/ When to Call ER<\/h2>\n<div class=\"dept-when\">\n<div class=\"dept-when__block\">\n<h3 class=\"dept-when__title\">Visit this department if:<\/h3>\n<ul class=\"dept-when__list\">\n<li>You have been diagnosed with or are suspected of having colorectal or rectal cancer<\/li>\n<li>You are seeking sphincter-preserving surgery<\/li>\n<li>You would like evaluation for robot-assisted or laparoscopic colorectal surgery<\/li>\n<li>You have fecal incontinence, rectal prolapse, or chronic bowel symptoms<\/li>\n<li>You are seeking treatment in Japan due to long waiting times in your home country<\/li>\n<\/ul><\/div>\n<div class=\"dept-when__block dept-when__block--er\">\n<h3 class=\"dept-when__title\">Call ER immediately if:<\/h3>\n<ul class=\"dept-when__list\">\n<li>Severe or worsening abdominal pain with fever or vomiting<\/li>\n<li>Suspected appendicitis (right lower abdominal pain, fever, nausea)<\/li>\n<li>Severe abdominal distension or inability to pass stool or gas<\/li>\n<li>Sudden severe abdominal pain with a rigid abdomen<\/li>\n<li>Significant rectal bleeding with dizziness or fainting<\/li>\n<\/ul>\n<p class=\"dept-when__note\">Emergency Room: open 24\/7. Walk-in accepted for emergencies.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n<p><!-- \u2500\u2500 Treatment Flow \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section\">\n<h2>Treatment Flow<\/h2>\n<ol class=\"dept-timeline\">\n<li class=\"dept-timeline__item\">\n<div class=\"dept-timeline__badge\">1<\/div>\n<div class=\"dept-timeline__content\">\n<h3>Initial consultation and assessment<\/h3>\n<p>Medical history, symptoms, and imaging are reviewed. Pre-travel assessment is available for overseas patients.<\/p>\n<\/p><\/div>\n<\/li>\n<li class=\"dept-timeline__item\">\n<div class=\"dept-timeline__badge\">2<\/div>\n<div class=\"dept-timeline__content\">\n<h3>Treatment planning<\/h3>\n<p>A personalised plan is developed based on diagnosis and clinical condition.<\/p>\n<\/p><\/div>\n<\/li>\n<li class=\"dept-timeline__item\">\n<div class=\"dept-timeline__badge\">3<\/div>\n<div class=\"dept-timeline__content\">\n<h3>Treatment and hospitalisation<\/h3>\n<p>Surgery or chemotherapy is performed with a focus on safety and functional outcomes.<\/p>\n<\/p><\/div>\n<\/li>\n<li class=\"dept-timeline__item\">\n<div class=\"dept-timeline__badge\">4<\/div>\n<div class=\"dept-timeline__content\">\n<h3>Follow-up<\/h3>\n<p>Post-treatment follow-up and coordination of ongoing care.<\/p>\n<\/p><\/div>\n<\/li>\n<\/ol>\n<\/section>\n<p><!-- \u2500\u2500 Contact \u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500 --><\/p>\n<section class=\"op-section\" id=\"contact\">\n<h2>Contact<\/h2>\n<div class=\"contact-cards\">\n<p>    <!-- Overseas patients --><\/p>\n<div class=\"contact-card contact-card--jmhc\">\n<div class=\"contact-card__eyebrow\">Patients from overseas<\/div>\n<h3 class=\"contact-card__title\">Contact us from overseas<\/h3>\n<p class=\"contact-card__lead\">\n        Start with a brief message to our International Medical Support Department.<br \/>\n        Please include your diagnosis, current condition, and the type of consultation or treatment you are seeking.<br \/>\n        We will review your case and guide you through<br \/>\n        the next steps.\n      <\/p>\n<ul class=\"ls-contact-icons\" style=\"margin-top:16px;\">\n<li>\n          <a href=\"https:\/\/lin.ee\/GRXNFOG\" class=\"ls-contact-icon ls-contact-icon--line\" target=\"_blank\" rel=\"noopener\"><br \/>\n            <i class=\"fa-brands fa-line\" aria-hidden=\"true\"><\/i><br \/>\n            <span class=\"sr-only\">LINE<\/span><br \/>\n          <\/a>\n        <\/li>\n<li>\n          <a href=\"https:\/\/wa.me\/818070945976\" class=\"ls-contact-icon ls-contact-icon--whatsapp\" target=\"_blank\" rel=\"noopener\"><br \/>\n            <i class=\"fa-brands fa-whatsapp\" aria-hidden=\"true\"><\/i><br \/>\n            <span class=\"sr-only\">WhatsApp<\/span><br \/>\n          <\/a>\n        <\/li>\n<li>\n          <a href=\"https:\/\/kishiwada.tokushukai.or.jp\/en\/contact.html\" class=\"ls-contact-icon ls-contact-icon--mail\" target=\"_blank\" rel=\"noopener\"><br \/>\n            <i class=\"fa-regular fa-envelope\" aria-hidden=\"true\"><\/i><br \/>\n            <span class=\"sr-only\">Online contact form<\/span><br \/>\n          <\/a>\n        <\/li>\n<\/ul>\n<p style=\"margin-top:14px;font-size:.92rem;\">\n        <a href=\"\/en\/international-treatment\/overview\/\">International Treatment Services \u2014 full details \u2192<\/a>\n      <\/p>\n<\/p><\/div>\n<p>    <!-- Living in Japan --><\/p><\/div>\n<\/section>\n<p><!-- Schema.org --><br \/>\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"WebPage\",\n      \"@id\": \"https:\/\/kishiwada.tokushukai.or.jp\/en\/departments\/lower-gi-surgery\/#webpage\",\n      \"url\": \"https:\/\/kishiwada.tokushukai.or.jp\/en\/departments\/lower-gi-surgery\/\",\n      \"name\": \"Colorectal Surgery Japan | Kishiwada Tokushukai Hospital\",\n      \"description\": \"Colorectal and rectal cancer surgery in Japan. 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No waiting lists. Why international patients choose us Sphincter-preserving surgery for rectal cancer \u2014 avoiding permanent colostomy where clinically appropriate da Vinci robotic surgery for colorectal cancer \u2014 precision and minimally invasive treatment Pelvic functional surgery for fecal [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":264,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-417","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/417","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/comments?post=417"}],"version-history":[{"count":17,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/417\/revisions"}],"predecessor-version":[{"id":426,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/417\/revisions\/426"}],"up":[{"embeddable":true,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/264"}],"wp:attachment":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/media?parent=417"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}