The top five categories are tachyarrhythmia, valvular disease, ischemic heart disease, bradyarrhythmia, and obliterative arteriosclerosis, demonstrating that cardiovascular care is provided in a balanced and diverse range.

In Respiratory Medicine, the largest number of patients are hospitalized for lung cancer testing and treatment (chemotherapy, radiation therapy, and immunotherapy). Most lung cancer testing is performed on an outpatient basis, except for bronchoscopy, which has a somewhat higher risk of complications and requires a two-day, one-night stay. For treatment using anticancer drugs, the initial anticancer drug treatment is generally 10-14 days, while immunotherapy is inpatient treatment for three days, and any side effects are monitored and dealt with promptly. Subsequent continued anticancer drug treatment is performed as either a short-term hospitalization or outpatient treatment.
The next most common reason is hospitalization due to respiratory failure caused by worsening interstitial pneumonia. In this case, patients are required to undergo treatment with oxygen inhalation, steroids, and immunosuppressants, which lengthens hospital stays to around two weeks.

In Gastroenterology, we see a large number of hospitalizations for endoscopic treatment of gastrointestinal tumors, bile duct stones, biliary and pancreatic tumors, biliary and pancreatic diseases such as chronic pancreatitis, and liver diseases.There are also many emergency hospitalizations for cases of cholangitis due to bile duct stones and obstructive jaundice due to biliary and pancreatic cancer, and we provide fast and safe endoscopic treatments (stent placement and stone extraction).
Additionally, for gastric and duodenal tumors and colon polyps, we strive to improve the quality of medical care by introducing clinical pathways for endoscopic mucosal resection and endoscopic submucosal dissection, thereby reducing the average length of hospital stay.
As a result, in almost all areas, we have achieved shorter turnaround times than the national average.

The Tokai University Department of Hematology-oncology covers a wide area, stretching from central Kanagawa Prefecture and the Shonan district to eastern Shizuoka, making it one of the leading university hospitals in the Tokyo metropolitan area. We provide comprehensive services for patients with hematological disorders, from diagnosis to advanced treatment, including hematopoietic stem cell transplantation. At our hospital, we diagnose approximately 200 new cases of malignant lymphoma each year. To confirm a diagnosis, we perform lymph node and tissue biopsies, followed by histopathological examination, cell surface marker testing, chromosome testing, genetic testing, and imaging tests to comprehensively diagnose and determine treatment options. Chemotherapy is the primary treatment for malignant lymphoma, but we also offer radiation therapy and autologous peripheral blood stem cell transplantation in appropriate cases, and, starting in 2024, CAR-T cell therapy. We provide chemotherapy for acute leukemia and myelodysplastic syndrome, and actively perform hematopoietic stem cell transplantation for refractory cases or those with poor prognosis. Multiple myeloma is a disease common among the elderly and has been increasing in recent years. In addition to promoting treatments including new therapeutic drugs, CAR-T cell therapy, a cancer immunotherapy, was introduced in 2023 and has been used in 21 cases of multiple myeloma. Our hospital actively conducts clinical trials, immune cell therapy, and hematopoietic stem cell transplants. We have performed an average of 40-50 allogeneic hematopoietic stem cell transplants per year. We work closely with nearby affiliated hospitals to create an environment where patients can choose the best treatment for them.

Rheumatology is a leading medical institution specializing in systemic autoimmune diseases in the western part of the prefecture, accepting and treating severe cases of collagen diseases and rheumatic diseases with multi-organ dysfunction. In particular, for systemic lupus erythematosus, antiphospholipid syndrome, and rheumatoid arthritis, we place emphasis on the effective use of targeted therapies such as appropriate biologics and immunosuppressants to minimize glucocorticoid (steroid) treatment. Rapidly progressive interstitial lung disease, central and peripheral neuropathy, and rapidly progressive glomerulonephritis and renal failure, which are often associated with various collagen diseases and rheumatic diseases, often have poor prognoses. For these patients, we aim for early recovery and discharge through the balanced use of advanced treatments and combination therapies that combine multiple medications. Furthermore, because these are long-term, chronic diseases, we consider the long-term prognosis of our patients and aim for social remission, which allows them to return to society at a high level.

Department of Neurology provides medical care to patients with disorders of the brain, spinal cord, peripheral nerves, and muscles. Our hospital has a robust emergency medical system, and we are seeing a growing number of inpatients with cerebrovascular disorders, including cerebral infarction. We provide thrombolytic (intravenous t-PA) therapy, endovascular treatment, and surgical treatment 24 hours a day in collaboration with Neurosurgery (Primary Stroke Center (PSC) and Core Hospital). We also treat many intractable diseases, including multiple sclerosis and myasthenia gravis, as well as other neuroimmune disorders, using a variety of the latest novel biological agents. We also treat many patients with neurodegenerative disorders, including Parkinson's disease. We also provide a wide range of cutting-edge medical care and treatment for common diseases, such as epilepsy and headaches.
Furthermore, for the treatment of cerebral infarction, we utilize the "Regional Stroke Collaboration Clinical Path" and provide treatment in cooperation with local hospitals and clinics, so even after transferring patients from our hospital, they can rest assured that they will continue to receive treatment at the facility to which they are transferred.

The Internal Medicine (General Internal Medicine) department focuses on primary care, general internal medicine, infectious disease treatment, intensive care, etc.
We treat many cases of pneumonia, aspiration pneumonia, urinary tract infections, skin and soft tissue infections, and severe infections such as sepsis throughout the year.

Department of Renal Endocrinology and Metabolism mainly handles detailed examinations and treatments, including renal biopsies, for patients with chronic kidney disease, the introduction of hemodialysis and peritoneal dialysis, and hospitalizations for the treatment of diabetic ketoacidosis and hyperosmolar hyperglycemic states.In outpatient clinics, we also provide specialized diagnosis, detailed examinations and treatments for many endocrine disorders, including diabetes and kidney disease, and collaborate with related surgical fields.

In Japan, the number of patients with progressing chronic kidney disease and chronic renal failure who are forced to choose renal replacement therapy (dialysis therapy and kidney transplantation) is on the rise.
Transplant Surgery regularly performs kidney transplants. However, patients who select hemodialysis or peritoneal dialysis require dialysis shunt creation and intraperitoneal dialysis catheter placement, respectively. We also handle these dialysis access-related surgeries during the initiation stage of dialysis. Dialysis shunt creation is often performed as an outpatient procedure, but due to the aging of patients and the presence of various complications, we perform it with a short hospital stay. Furthermore, the progress of dialysis shunts after surgery must be monitored over the long term. Transplant Surgery follows up on progress, and if a malfunction occurs in the surgical dialysis access, requiring hospitalization, we perform repair surgery with a short hospital stay. Most "surgery due to complications from surgery or procedures" refers to such cases. Some cases require surgery, while others do not. In other words, we act as a primary care physician for dialysis patients with chronic kidney failure, working in collaboration with our hospital's Department of Renal Endocrinology and Metabolism, and Metabolism.
Kidney transplant patients visit the outpatient department of Transplant Surgery on a regular basis, but may require additional treatment for urinary tract infections or other viral infections. To accurately assess rejection and the condition of the transplanted kidney, transplant kidney biopsies may be performed with a short hospital stay. Furthermore, for patients with nephrogenic hyperparathyroidism and primary hyperparathyroidism, which are complications of chronic renal failure, and who are suitable for surgery, Transplant Surgery Department provides medical care and surgery in collaboration with Department of Renal Endocrinology and Metabolism, and Metabolism.

With the primary goal of providing Cardiovascular Surgery treatment of world-class standards, we provide a wide range of surgical treatments for acquired heart diseases such as ischemic heart disease (typically angina pectoris), valvular heart disease, and arrhythmia, aortic diseases centered on aortic aneurysms and aortic dissection, congenital heart disease, and arteriovenous diseases of the limbs and internal organs, including arteriosclerosis obliterans.
Our hospital is committed to fulfilling its mission of contributing to regional emergency medical care and is a facility that actively provides advanced emergency medical care. Many patients have aortic or peripheral vascular problems, with over 30% of these requiring emergency surgery. Since 2011, we have been able to operate two cardiopulmonary bypass machines in parallel, allowing us to proactively perform open-heart surgery even in emergency cases. At the same time, we also perform many less physically demanding stent graft insertion procedures for elderly patients and those with preoperative complications. We treat over 70 cases of acute aortic dissection annually, including those treated conservatively, with the majority of these patients being transferred by ambulance from hospitals in the Seisho area.
In recent years, the number of elderly people with valvular heart disease has been increasing, and we are particularly focusing on valve-sparing root replacement for aortic valve regurgitation caused by aortic root dilatation, mitral valve repair (performed in 90% of mitral valve surgeries, with most remaining patients receiving bioprosthetic valve replacement), and Maze surgery for atrial fibrillation.Since 2017, we have operated a hybrid operating room, and have performed over 100 TAVI (catheter-assisted aortic valve replacement) procedures.

The most common disease we treat is primary lung cancer, and we actively perform surgery aimed at a cure, and also administer postoperative adjuvant chemotherapy to prevent recurrence.For lung cancer that is difficult to remove, we also provide multidisciplinary therapy including chemotherapy and radiation therapy.
We also perform surgery for lung metastases from cancers in other organs after determining whether the surgery is appropriate.
Mediastinal tumors are also a target of treatment, and we actively perform surgery. In particular, we provide multidisciplinary treatment that combines chemotherapy and radiation therapy for malignant mediastinal tumors.

Malignant esophageal tumors: Esophageal cancer treatment follows the "Esophageal Cancer Treatment Guidelines," and we offer endoscopic treatment, surgery, chemotherapy, chemoradiotherapy, and immune checkpoint inhibitors depending on the stage of the cancer. We also actively perform robotic surgery to reduce the burden on patients. When selecting treatment, we consider the patient's overall condition and the presence of other illnesses, and consult with the patient and their family to select the best treatment method. We receive patient referrals from all over the country and actively treat severely ill patients. Many of our patients also suffer from cardiovascular, respiratory, and neurological diseases, and we work in collaboration with other departments to provide safe and reliable treatment.
Malignant tumors of the colon: Clinical trials have confirmed the safety and effectiveness of laparoscopic surgery for malignant tumor colectomy for rectal cancer, and since April 2019, more than 95% of procedures have been performed using laparoscopic surgery. We have also introduced robot-assisted surgery in an effort to preserve function.
Inguinal hernia: As a university hospital with advanced medical resources, we work with each department to handle inguinal hernia surgery for patients with many complications. We also use clinical pathways to ensure efficient treatment. After consulting with the patient, we perform laparoscopic surgery (TAPP) and inguinal surgery (Lichtenstein method, etc.).
Pancreatic tumors: The number of hospitalized patients is increasing along with the increase in patients undergoing pre- and post-operative chemotherapy. We have also introduced robotic surgery, which has produced good results.

In Breast Surgery, more than 90% of hospitalizations are for breast cancer surgery. Other cases include hospitalizations for treatment of advanced or recurrent breast cancer, and benign diseases requiring general anesthesia. The top two types of surgery have different numbers of cases, but the only difference is the surgical procedure; all are breast cancer. These include partial mastectomy, total mastectomy + axillary lymph node dissection, and sentinel lymph node biopsy.
Breast cancer is the most common disease among women, and Breast Surgery provides comprehensive medical care, from diagnosis and treatment to terminal care. Our hospital is a facility certified by the Japan Breast Cancer Society, and performs surgery on approximately 300 breast cancer patients annually. We also receive referrals from across the country for advanced and recurrent breast cancer patients, and provide treatment for them. Our principle is to provide evidence-based medical care. For each patient, we hold joint conferences with departments such as pathology, radiology, and ultrasound diagnosis to determine the treatment plan. We are a pioneer in molecular targeted therapy, and actively participate in the development of new therapeutic drugs and clinical techniques.

Pediatric Surgery treats surgical conditions in infants through 15 years of age. Pediatric Surgery treats a wide range of conditions, including respiratory (trachea, lungs, tunica transversa, etc.), digestive (digestive tract, liver, bile duct, spleen, pancreas, etc.), urinary (kidneys, ureters, bladder, urethra, penis, etc.), reproductive (uterus, ovaries, vulva, etc.), skin, soft tissue, and cervical (skin, muscle, cervical fistula, etc.), making it difficult to accurately represent the diverse patient populations seen in Pediatric Surgery. Laparoscopic surgery for inguinal hernias and upper gastrointestinal endoscopy, which are common procedures, can be safely performed on an outpatient basis. As a certified facility with a full-time physician certified by the Japanese Society of Pediatric Surgery Surgery and a Japanese Society of Endoscopic Surgery certified surgeon (Pediatric Surgery), we serve as a core facility for pediatric care in western Kanagawa Prefecture. We strive to provide thorough explanations that consider the feelings of families, asking ourselves, "How would I make this decision if it were my child?" As our department covers a wide area in western Kanagawa Prefecture, babies discovered in the neonatal or fetal stage are treated at Center for Comprehensive Perinatal Medicine, which works in cooperation with pediatrics and obstetrics departments and utilizes cutting-edge medical technology as a base for perinatal care, while infants and older children are treated in the specialized pediatric ward. Since 2019, we have been visiting nearby core medical facilities to provide feedback on perioperative information on patients referred by them, and we are working to build strong regional collaboration based on a "face-to-face pediatric medical collaboration" that aims to build smoother, more trusting relationships.

The first patient underwent detailed cerebral angiography examination to determine the need for treatment for an unruptured cerebral aneurysm.
The second patient underwent embolization via catheter surgery for an unruptured cerebral aneurysm.
The third type of non-traumatic intracranial hematoma is intracerebral hemorrhage, a condition in which high blood pressure causes the small blood vessels in the brain to become fragile, resulting in bleeding. Blood pressure control is paramount, but if the hemorrhage is large, it may be necessary to perform surgery to remove it in order to save the patient's life.
The fourth group are patients with brain tumors that occur inside the skull and who have had the tumor removed by surgery.
The fifth type is cranial/intracranial injuries, including patients with brain contusions due to trauma and acute subdural hematomas, which are bleeding on the surface of the brain.

In plastic surgery, as the population ages, the number of patients with lower back and joint pain as their main complaint continues to increase.
In particular, spinal diseases such as spinal stenosis and spinal deformity account for a large proportion of cases, and there is a growing need for treatment for patients suffering from chronic pain and walking difficulties.
There are also many cases involving revision of artificial joints for shoulder arthritis, knee arthritis, and hip arthritis, which are closely related to the decline in motor function caused by aging.
For these diseases that have a significant impact on activities of daily living, our department strives to provide careful and appropriate medical treatment tailored to the condition of each patient.
We have specialists in various fields, such as the spine and joints, and we also have an emergency medical center that can handle severe injuries and acute illnesses.
We will continue to deepen our collaboration with local medical institutions and strive to provide safe and reliable plastic surgery care.

plastic surgery The Department of Oral and Maxillofacial Surgery at plastic surgery covers almost all diseases in the area of maxillofacial surgery, including pediatric congenital anomalies (cleft lip and palate, microtia, premature skull fusion, congruency polydactyly, etc.), jaw deformities, skin tumors, trauma (facial injuries, burns), reconstruction after resection of breast and head and neck cancer, and bruise treatment using lasers. In particular, we have been actively treating cleft lip and palate, jaw deformity surgery, facial bone fractures, and other maxillofacial surgical treatments since the opening of the clinic, and we believe this is the reason for the large number of cases we have treated.
The number of patients with ptosis has been increasing due to the spread and awareness of surgery for senile ptosis, which has led to an increase in referrals from the neighboring ophthalmology.
In addition, in collaboration with Breast Surgery, we are actively performing breast reconstruction, including silicone implants and autologous tissue reconstruction using free skin valves, according to each patient's needs.

The top ranking for 2024 was "Disabilities related to shortened gestational age and low birth weight (birth weight 2500g or more), no surgery, surgery/treatment 2-1 performed." Fourth and fifth places also included "Disabilities related to shortened gestational age and low birth weight (2500g or more), no surgery, no surgery/treatment 2" and "Disabilities related to shortened gestational age and low birth weight (1500g to less than 2500g), no surgery, surgery/treatment 2-1 performed," both of which were neonatal conditions, indicating a high number of hospitalizations for neonatal conditions. We believe this is partly due to efforts to accept as many high-risk newborns as possible, not only those born within the hospital, but also those born within the block.
Coming in second place was "Inflammation of the esophagus, stomach, duodenum, or other intestines (other benign diseases) No surgery No surgery/treatment 1 No surgery/treatment 2," which had not been in the top five for the past few years. We believe this is a result reflecting the prevalence of viral gastroenteritis.
The third place was "acute leukemia, surgery, surgery/treatment, etc. 2-2," which was the first place last year. Our hospital is one of the few facilities in Kanagawa Prefecture that can treat pediatric hematological and neoplastic diseases, so we believe this may be related to the fact that we received many referrals from outside the block.

The obstetrics department serves as Center for Comprehensive Perinatal Medicine responsible for perinatal maternal and child medical care in Kanagawa Prefecture, and receives many cases of high-risk pregnancies and abnormal bleeding after delivery that are referred or transferred from other hospitals. As a result, there are many cases of premature birth, threatened premature labor, and abnormalities of the fetus and fetal appendages such as placenta previa.

The gynecology department provides specialized treatment for a variety of diseases. In particular, for malignant diseases, we have established a system that allows for multidisciplinary treatment including surgery, radiation therapy, and drug therapy, and in recent years, the number of drug therapy treatments has been increasing.

Our hospital has a flexible treatment system in place to meet the needs of our patients. In particular, for cataract surgery, we offer a two-day, one-night hospital stay even for simultaneous surgery on both eyes to reduce the burden on patients. This allows patients to return to their daily lives as quickly as possible. For glaucoma treatment, we select the most appropriate treatment for each patient's individual situation, and work to halt the progression of glaucoma and preserve their vision.
We also receive many patients who require (semi-)emergency surgery for conditions such as retinal detachment and trauma, and in order to respond promptly to these cases, we place importance on close cooperation with the wards and operating rooms.We have a system in place to provide prompt and accurate treatment in emergencies.
Furthermore, our hospital not only treats patients undergoing surgery, but also treats patients who require medication for uveitis, optic neuritis, thyroid disease, etc. For these cases, we provide comprehensive treatment in collaboration with other departments, so that we can provide optimal treatment that takes into account the patient's overall health.
In this way, our hospital has established a system that can respond to a wide range of treatment needs, from surgery to drug therapy, and strives to provide the best possible medical care for each patient.

In dermatology, we actively perform removal of benign and malignant skin tumors, including on relatively elderly patients.
We also actively treat intractable diseases and severe cases such as autoimmune bullous disease and severe alopecia.

1. 1. Our hospital was one of the first in Japan to introduce high-precision prostate biopsies (prostate needle biopsy using MRI and ultrasound fusion images), and we perform robot-assisted radical prostatectomy, radiation therapy, focal therapy (implemented as advanced medical care), and surveillance therapy according to the condition of each patient diagnosed with prostate cancer.
2. 2. We actively perform transurethral bladder tumor resection for bladder cancer diagnosed at our hospital or referred to us. Our hospital is the secretariat for creating the 2023 edition of the Hematuria Diagnostic Guidelines, and it is not uncommon for bladder cancer to be diagnosed in patients who have occult blood in their urine during a medical checkup.
3. 3. At our hospital, we consider prostate cancer treatment methods based on the individual patient's condition. The average length of hospital stay for robot-assisted radical prostatectomy at our hospital is significantly lower than the national average, and treatment can be performed with a short hospital stay.
4. 4. Our hospital actively implements drug therapy for bladder cancer. Even in advanced bladder cancer, if the tumor shrinks with drug therapy, we will perform removal surgery using robot-assisted surgery.
5. 5. Our hospital actively performs endoscopic surgery using lasers for urinary tract stones. For large kidney stones, we also perform ECIRS (percutaneous transurethral lithotripsy).

Drug addiction occurs when people take excessive amounts of prescription or over-the-counter drugs, and the number of cases is increasing every year, affecting a wide range of ages, both older and younger. The severity of the condition varies depending on the type of drug taken, and while most cases can be improved with conservative treatment such as infusions, some types can become more serious or even fatal.
Most cranial and intracranial injuries are caused by falls, trips, traffic accidents, etc., and there has been a particular increase in the number of falls among the elderly. Patients are often monitored for concussions or loss of consciousness, and open wounds on the scalp or face are sutured. However, due to the increasing number of people taking anticoagulants and other medications that inhibit blood clotting, brain surgery may sometimes be required.
Disorders of the autonomic nervous system can cause a condition called transient ischemic attack (syncope), which is often caused by arrhythmia and is seen in elderly people.
Cervical spinal cord injuries are a condition in which the bones of the neck (cervical vertebrae) and the cervical spinal cord that runs through them are damaged. While injuries were often sustained in traffic accidents, there has been an increase in minor injuries caused by falls among the elderly. Overall, as society ages, there has been an increase in diseases related to the elderly.

The Department of Otolaryngology, Head and Neck Surgery treats many patients with head and neck cancer. In addition to patients undergoing radical surgery, we also treat many patients who undergo non-surgical radiation chemotherapy. We work closely with Department of Radiation Therapy to improve treatment outcomes while preserving organ function. Even for malignant diseases, we shorten the average length of hospital stay, striking a good balance between short-term inpatient and outpatient treatment. We also adopted chemotherapy and immunotherapy for recurrent and metastatic head and neck cancer early on, achieving favorable treatment outcomes in collaboration with cancer chemotherapy specialists. We actively perform surgery in collaboration with other departments within the hospital, even for patients with post-treatment recurrence, widespread disease progression, or multiple pre-existing conditions.
When performing surgery on head and neck tumors, including those in the salivary glands, it is important to preserve the function of the facial nerve, which is responsible for facial expressions, and we strive to perform surgery with fewer complications by using neuromonitoring.We also perform minimally invasive surgeries, including robotic surgery and Aluminox therapy (photoimmunotherapy).
Surgery for chronic sinusitis is performed using endoscopes and navigation systems, with short hospital stays of 4-5 days. In addition to general endoscopic sinus surgery, we are also actively introducing new surgical techniques.
We also actively perform otologic surgeries such as tympanoplasty for chronic otitis media and cholesteatomatous otitis media, and cochlear implantation for severe hearing loss. We have introduced new surgical drill systems, facial nerve monitoring, intraoperative CT scans, and other equipment, and are working to improve hearing improvement outcomes while maintaining safety.

The top three procedures are myocardial ablation for arrhythmia, percutaneous aortic valve replacement for aortic stenosis, and endovascular dilation of the limbs, demonstrating a well-balanced approach to comprehensive cardiovascular care. Regarding PCI, the number of procedures for coronary stent placement and acute myocardial infarction is roughly equal, which is in line with the global standard. Overall, the hospital provides very well-balanced, cutting-edge medical care. Furthermore, the average length of hospital stay is shorter than the national average, which is likely an indication of safe and efficient medical care.

When a patient experiences life-threatening massive hemoptysis, catheter therapy is effective in blocking the bronchial arteries with coils or other devices. Similar catheter therapy is also performed for a condition known as pulmonary arteriovenous fistula, in which a portion of the pulmonary artery and vein are directly connected. Respiratory Medicine works in cooperation with Department of Diagnostic Imaging to perform this type of endovascular therapy.
When malignant tumors such as lung cancer metastasize to the spine, we provide treatment in cooperation with plastic surgery and Department of Radiation Therapy also cooperate with Department of Palliative Care to actively alleviate symptoms such as pain.
In cases of empyema, in addition to thoracic drainage, long-term antibiotic administration is required, and the patient's hospital stay is longer, but in cooperation with Thoracic Surgery, we provide aggressive treatment, including curettage.We may also perform gastrostomy for patients with severe aspiration who have difficulty eating.

In Gastroenterology, we are divided into teams specializing in the digestive tract, liver, and biliary and pancreatic diseases, and provide treatment with a high level of expertise.
In addition to endoscopic mucosal resection for colon polyps, the gastrointestinal team actively performs minimally invasive treatments such as endoscopic submucosal dissection for early-stage malignant tumors in various parts of the gastrointestinal tract, as well as endoscopic gastrointestinal hemostasis, which is often performed in emergencies.
The biliary and pancreatic team performs endoscopic biliary stent placement for biliary and pancreatic tumors and bile duct stones, while the liver team performs selective arterial chemoembolization for hepatocellular carcinoma, requiring short-term hospitalization.

The Tokai University Department of Hematology-oncology covers a wide area, stretching from central Kanagawa Prefecture and the Shonan district to eastern Shizuoka, making it one of the leading university hospitals in the Tokyo metropolitan area. We provide comprehensive services for patients with hematological disorders, from diagnosis to advanced treatment, including hematopoietic stem cell transplantation. At our hospital, we diagnose approximately 200 new cases of malignant lymphoma each year. To confirm a diagnosis, we perform lymph node and tissue biopsies, followed by histopathological examination, cell surface marker testing, chromosome testing, genetic testing, and imaging tests to comprehensively diagnose and determine treatment options. Chemotherapy is the primary treatment for malignant lymphoma, but we also offer radiation therapy and autologous peripheral blood stem cell transplantation in appropriate cases, and, starting in 2024, CAR-T cell therapy. We provide chemotherapy for acute leukemia and myelodysplastic syndrome, and actively perform hematopoietic stem cell transplantation for refractory cases or those with poor prognosis. Multiple myeloma is a disease common among the elderly and has been increasing in recent years. In addition to promoting treatments including new therapeutic drugs, CAR-T cell therapy, a cancer immunotherapy, was introduced in 2023 and has been used in 21 cases of multiple myeloma. Our hospital actively conducts clinical trials, immune cell therapy, and hematopoietic stem cell transplants. We have performed an average of 40-50 allogeneic hematopoietic stem cell transplants per year. We work closely with nearby affiliated hospitals to create an environment where patients can choose the best treatment for them.

In Department of Neurology, we perform gastrostomy for patients who have difficulty taking food orally, mainly those with cerebrovascular disorders, Parkinson's disease, and degenerative diseases.In addition, for Parkinson's disease, we perform deep brain stimulation (DBS), levodopa-carbidopa enteral therapy (LCIG), and continuous subcutaneous infusion therapy (Vialev) in collaboration with the Department of Neurosurgery.
We perform tracheotomy and CV port construction in patients with cerebrovascular disorders, myasthenia gravis, amyotrophic lateral sclerosis, multiple system atrophy, etc.
For internal carotid artery stenosis, we perform percutaneous carotid artery stent placement after a thorough evaluation of the cerebral vascular system.
In addition, implantable electrocardiogram recordings are performed to investigate the cause of cryptogenic cerebral infarction.

The most common surgeries performed during hospitalization in Department of Renal Endocrinology and Metabolism are procedures performed by Transplant Surgery to introduce hemodialysis or peritoneal dialysis, or when vascular access failure occurs. This also includes parathyroidectomies performed by Transplant Surgery for primary and secondary hyperparathyroidism.

In Transplant Surgery, patients with chronic renal failure who have chosen hemodialysis therapy require dialysis access surgery (internal shunt placement, artificial vascular bypass graft, brachial artery superficialization). These procedures can be performed as outpatient procedures, but can also require short-term hospitalization depending on the patient's risk. Furthermore, a good dialysis shunt is essential for efficient hemodialysis. It is not uncommon for dialysis shunts to develop problems (shunt stenosis, occlusion, shunt arterio-varicose vein, shunt venous hypertension, etc.). Transplant Surgery department is also responsible for repairing such dialysis shunts.
We perform parathyroidectomy on patients who are candidates for surgery for hyperparathyroidism, a complication of chronic renal failure. However, Transplant Surgery also performs a similar surgery (parathyroid adenoma hyperplasia surgery) on patients with primary hyperparathyroidism who do not have renal failure.

In 2024, 747 patients underwent surgery in our department, including 637 open-heart surgeries using cardiopulmonary bypass and thoracic and abdominal aortic surgeries, 44 peripheral artery surgeries, and numerous lower limb varicose vein surgeries. Surgical procedures included 66 coronary artery bypass surgeries, 310 valve repairs and replacements, and 208 thoracic and abdominal aortic artificial vascular replacements or stent graft placements. Tokai University Hospital is a facility actively providing advanced emergency medical care, with more than 30% of aortic and peripheral vascular surgeries being emergency procedures. We also treat more than 70 cases of acute aortic dissection annually, including those treated conservatively. Many of these patients are transferred by ambulance from hospitals in the Seisho area.
Our areas of particular focus include left ventricular repair procedures, such as the Doll procedure for ischemic cardiomyopathy (over 100 cases performed since 2002), autologous valve-sparing root replacement for aortic regurgitation due to aortic root dilatation (over 50 cases performed), mitral valve repair (performed in 90% of mitral valve surgeries), Maze procedures for atrial fibrillation (32 cases performed in 2024), and stent graft placement for aortic aneurysms (46 cases performed in 2024). Since 2011, we have had two parallel cardiopulmonary bypass machines, and since 2017, we have had access to a hybrid operating room, enabling not only hybrid surgery but also emergency care during scheduled surgery. We also perform minimally invasive surgical procedures (MICS) upon request. We believe we can further contribute to regional medical care.

We actively perform thoracoscope-assisted surgery for primary lung cancer, metastatic lung tumors, benign lung tumors, spontaneous pneumothorax, etc., and the proportion of thoracoscope-assisted surgery is increasing. We also perform extended surgery for advanced primary lung cancer with the aim of curing it.
We also perform many surgeries for mediastinal tumors, and depending on the case, we perform median sternotomy or thoracoscopic surgery.

Laparoscopic colon resection for malignant tumors, colectomy (total resection, subtotal resection, or malignant tumor surgery): Since April 2019, more than 95% of all Gastroenterological Surgery have been performed using laparoscopy. This minimally invasive procedure contributes to shortening postoperative hospital stays. We also safely perform robotic-assisted surgery for rectal and colon cancer. However, in cases of highly advanced cancer, open surgery is performed, but this rate remains below 5%.
Hernia surgery (inguinal hernia): As a university hospital with advanced medical resources, we work with each department to perform surgery on patients with numerous complications. Laparoscopic surgery for inguinal hernias was introduced in 2012, and to date, no serious complications, including recurrence, have occurred. The small incision results in minimal pain, resulting in excellent cosmetic results and allowing patients to return to their daily lives quickly. We also perform inguinal hernia surgery, and after consulting with patients, we offer laparoscopic surgery (TAPP) and inguinal surgery (Lichtenstein method, etc.). We also use clinical pathways to ensure efficient treatment.
Laparoscopic cholecystectomy: A feature of our hospital is that we see many cases of severe inflammation, such as chronic cholecystitis. We often provide medical care in cooperation with Gastroenterology. Although we do experience difficult cases, we strive to perform safe surgeries and have achieved good surgical results. Laparoscopic surgery leaves a small incision and is less painful, so although the surgery is more difficult, we perform it as standard treatment, taking into account the patient's postoperative course.
Thoracoscopic esophageal malignant tumors: We perform robotic surgery as a standard procedure, striving to reduce the burden on patients. It has been reported that robotic surgery reduces recurrent laryngeal nerve paralysis. One of the features of our hospital is that we have a relatively large elderly population, and many patients have diseases of the circulatory system, respiratory system, and neurological system, so we strive to provide safe and reliable treatment in collaboration with other departments. We consider the patient's overall condition and the presence or absence of other diseases, and consult with the patient and their family to select the best treatment method.

Starting in fiscal year 2022, the number of Breast Surgery surgeries performed by mastectomy with sentinel lymph node biopsy in breast surgery surpassed that of partial mastectomy (breast-conserving surgery) with sentinel lymph node biopsy. In recent years, the rate of partial mastectomy (breast-conserving surgery) has declined. Reasons for this include improved diagnosis of secondary cancers through preoperative MRI, the widespread use of breast reconstruction, and insurance coverage for implants. Our hospital actively performs partial mastectomy, total mastectomy, and breast reconstruction in collaboration with plastic surgery, depending on the patient's condition. While patients are generally required to be admitted to the hospital the day before surgery, additional time may be required before surgery due to anticoagulant therapy and perioperative management of coexisting conditions. The hospital stay is approximately four days for partial mastectomy with sentinel lymph node biopsy and approximately seven to eight days for total mastectomy with sentinel lymph node biopsy or axillary lymph node dissection.

Pediatric Surgery treats surgical conditions in infants through 15 years of age. Pediatric Surgery treats a wide range of conditions, including respiratory (trachea, lungs, tunica transversa, etc.), digestive (digestive tract, liver, bile duct, spleen, pancreas, etc.), urinary (kidneys, ureters, bladder, urethra, penis, etc.), reproductive (uterus, ovaries, vulva, etc.), skin, soft tissue, and cervical (skin, muscle, cervical fistula, etc.), making it difficult to accurately represent the diverse patient populations seen in Pediatric Surgery. Laparoscopic surgery for inguinal hernias and upper gastrointestinal endoscopy, which are common procedures, can be safely performed on an outpatient basis. As a certified facility with a full-time physician certified by the Japanese Society of Pediatric Surgery Surgery and a Japanese Society of Endoscopic Surgery certified surgeon (Pediatric Surgery), we serve as a core facility for pediatric care in western Kanagawa Prefecture. We strive to provide thorough explanations that consider the feelings of families, asking ourselves, "How would I make this decision if it were my child?" As our department covers a wide area in western Kanagawa Prefecture, babies discovered in the neonatal or fetal stage are treated at Center for Comprehensive Perinatal Medicine, which works in cooperation with pediatrics and obstetrics departments and utilizes cutting-edge medical technology as a base for perinatal care, while infants and older children are treated in the specialized pediatric ward. Since 2019, we have been visiting nearby core medical facilities to provide feedback on perioperative information on patients referred by them, and we are working to build strong regional collaboration based on a "face-to-face pediatric medical collaboration" that aims to build smoother, more trusting relationships.

The first type of endovascular surgery (catheter surgery) involves mainly coil embolization of cerebral aneurysms. We also perform many surgeries to selectively block abnormal (diseased) blood vessels in cases of dural arteriovenous fistulas and cerebral venous malformations, which are blood vessels with diseased areas that differ from the normal blood flow.
Brain tumors that are candidates for the second type of intracranial tumor resection are divided into primary brain tumors that arise from the cells that make up the brain and metastatic brain tumors that metastasize from malignant tumors outside the brain. Primary brain tumors include meningiomas that arise from the meninges that surround the brain, gliomas that arise from the brain parenchyma, pituitary adenomas that arise from the pituitary gland, schwannomas that arise from the nerve sheaths, and primary central nervous system malignant lymphomas that arise within the brain and spinal cord. We perform safe and highly effective surgeries using auxiliary diagnostics such as intraoperative imaging diagnosis and the use of electrical stimulation to check the function of nerves affected by the disease. Our hospital has a particularly high number of surgical cases of malignant brain tumors and skull base tumors.
The third type, chronic subdural hematoma drilling and irrigation, is a surgery performed under local anesthesia to treat chronic subdural hematomas, which are chronic accumulations of blood between the skull and brain. This condition is often triggered by a minor head injury and is commonly seen in older people.
The fourth, intracranial microvascular decompression, is a surgery that moves the blood vessels that are compressing the cranial nerves and causing nerve damage, thereby relieving the pressure on the nerves.We use auxiliary diagnostics, such as checking the function of the nerves using electrical stimulation during surgery, to perform a safe and highly effective surgery.
The fifth type, cerebral aneurysm neck clipping, is a surgery for cerebral aneurysms, but unlike the first type, which uses a catheter, it involves a craniotomy under general anesthesia, direct access to the cerebral aneurysm, and complete occlusion of the neck of the aneurysm with a metal clip. It is characterized by a high cure rate, but because it is a surgery that involves a craniotomy, a specialist will select the most appropriate method for each patient depending on their condition and propose the best method for each patient.

In plastic surgery, surgeries for age-related diseases are on the rise as society ages. In particular, for osteoarthritis caused by worn cartilage, "artificial joint replacement (shoulder, hip, knee)" is the most commonly performed procedure, contributing to pain relief and functional recovery.
We also frequently perform "spinal fixation surgery" to treat spinal nerve compression and deformity, and these procedures together constitute one of the main types of surgery at our hospital. Spinal diseases often cause chronic pain, numbness, and difficulty walking, so appropriate surgery and postoperative rehabilitation are important.
At our hospital, we thoroughly evaluate preoperative imaging and overall condition to create the optimal treatment plan for each patient. By promoting minimally invasive surgery and starting rehabilitation early, we aim to shorten the average length of hospital stay and enable patients to return to society as soon as possible.
Furthermore, we are strengthening our ties with local rehabilitation facilities depending on the patient's age or post-operative condition, and have established a system where patients can receive continuous rehabilitation with peace of mind. We will continue to strive to provide safe, high-quality plastic surgery medical care.

plastic surgery provides treatment for almost all diseases in the field of plastic surgery. Ptosis surgery can be performed as an outpatient procedure or with a short hospital stay. For breast reconstruction after breast cancer surgery, we select either autologous tissue reconstruction using free flaps or artificial breast reconstruction using silicone implants depending on the case. Mandibular reconstruction is planned to achieve not only a good occlusion but also a balanced facial appearance. We perform surgical correction surgery for jaw deformities in collaboration with orthodontists.

Because the obstetrics (Obstetrics and Gynecology) department plays a role as Center for Comprehensive Perinatal Medicine, it accepts many high-risk cases related to childbirth, and there are many diseases related to cesarean sections.In some cases, in order to save the mother's life, it also performs hemostatic procedures (such as vascular embolization) using angiography techniques to control bleeding and hysterectomies.

In the gynecology department, we perform a wide range of surgeries, from benign to malignant diseases. We are actively introducing laparoscopic surgery and robot-assisted surgery, which are less invasive than open surgery, and the number of treatments using these methods is increasing.

Lens reconstruction surgery: Lens reconstruction surgery is the most common surgery performed, and is a particular focus at our hospital. We have introduced the latest technology and equipment, and strive to improve the selection of intraocular lenses and surgical techniques to maximize postoperative visual recovery.
Microsurgical vitreous stalk detachment: Microsurgical vitreous stalk detachment, including retinal attachment, is an important surgery in the treatment of retinal detachment and diabetic retinopathy. Our hospital has highly skilled specialists on-site and is equipped to handle particularly difficult cases. We also utilize the latest surgical equipment to maximize the safety and effectiveness of the surgery.
Glaucoma treatment: There are various surgical methods for treating glaucoma, including implant insertion, but our clinic focuses on plate-less implant surgery. We select the most appropriate treatment method based on each patient's individual situation, and work to halt the progression of glaucoma and preserve vision.
Lens reconstruction surgery (insertion of sutured lenses): In cases where the zonule is weak or the capsular support is insufficient, we actively employ a method to fix the intraocular lens to the sclera. This procedure requires advanced skills, but at our hospital, highly specialized doctors perform the surgery, aiming to achieve stable lens fixation and good postoperative vision. Furthermore, we utilize the latest equipment and technology to enhance safety and reliability.
As mentioned above, in order to provide the best possible treatment for each patient, our hospital is constantly pursuing the latest technology and knowledge, and we prioritize the safety and effectiveness of surgery.

In dermatology, we perform removal of malignant and benign skin tumors with short-term hospitalization.

1. 1. We actively perform transurethral bladder tumor resection for bladder cancer diagnosed at our hospital or referred to us. Our hospital is the secretariat for creating the 2023 edition of the Hematuria Diagnostic Guidelines, and it is not uncommon for bladder cancer to be diagnosed in patients who have occult blood in their urine during a medical checkup.
2. 2. At our hospital, we consider the best prostate cancer treatment method based on the individual patient's condition. Robot-assisted radical prostatectomy at our hospital requires a short hospital stay of 7 to 8 days.
3. 3. Our hospital actively performs endoscopic surgery using lasers for urinary tract stones. For large kidney stones, we also perform ECIRS (percutaneous transurethral lithotripsy).
4. 4. Our hospital actively performs robot-assisted partial nephrectomy for kidney cancer. The length of hospital stay is 6 to 7 days, which is significantly lower than the national average, and treatment can be performed with a short hospital stay.
5. 5. At our hospital, we promptly place ureteral stents in patients who visit the emergency center with acute pyelonephritis caused by urinary stones to improve the infection.

Spinal fixation and open fracture surgery are often performed due to injury mechanisms such as traffic accidents and falls, and after surgery, patients may move on to rehabilitation while monitoring their overall condition. In cases where loss of consciousness persists or artificial ventilation management is prolonged, further ventilator support and sputum suctioning will be required, so a tracheotomy will be performed. Vascular embolization is performed to stop internal bleeding caused by pelvic fractures due to traffic accidents or abdominal organ damage such as the liver and spleen. Such severe injuries often involve fractures, and external fixation and open reduction are performed.

Endoscopic nasal and sinus surgery for chronic sinusitis involves removing lesions called nasal polyps, which have formed due to chronic inflammation in the sinuses, and opening the septum of the inflamed sinus to allow it to communicate with the nasal cavity. This procedure is performed using a clinical pathway and requires a short hospital stay of just five days. Instead of using conventional gauze, we use a hemostatic agent that does not need to be removed, reducing the burden on the patient.
We perform bilateral tonsillectomy for chronic tonsillitis, focal tonsillar infections, and sleep apnea syndrome. Highly precise techniques allow for surgery with minimal bleeding and pain. In cooperation with the admission and discharge center, patients are admitted the day before surgery, and the average length of stay is short, at around one week. Furthermore, since bleeding can occur after discharge from the hospital after tonsillar surgery, we provide guidance on dietary guidelines after discharge and on what to do in case of bleeding during hospitalization, and discharge patients only after alleviating their anxiety.
Neck dissection for head and neck cancer is a surgical procedure to remove fat and connective tissue from the neck, including lymph nodes metastasized by malignant tumors. While ensuring a sufficient area of resection to control the tumor, we are also careful to preserve the various nerves and important blood vessels that run through the neck, and to minimize any aftereffects that may affect daily life after surgery.
Tympanoplasty, performed for chronic otitis media and cholesteatomatous otitis media, is a surgery that aims to improve hearing by removing chronic inflammation and cholesteatoma lesions as well as reconstructing the ossicles and eardrum. During preoperative imaging tests, we make full use of the latest diagnostic imaging device called photon counting CT to conduct detailed evaluations, and during surgery we have introduced equipment such as a new surgical drill system, facial nerve monitoring, and intraoperative CT scans, and are working to improve hearing improvement outcomes while paying close attention to safety.
Superficial lobectomy for benign parotid tumors requires surgery that preserves the facial nerve, and we take great care to avoid complications during the six-day hospital stay.