What is advanced medical care?
Advanced medical care refers to medical procedures approved by the Minister of Health, Labour and Welfare as cutting-edge technology that exceeds the medical standards covered by insurance due to new medical technology and the diversification of patient needs.
Advanced Medical Care A
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Unapproved or off-label drugs or medical technologies that do not involve the use of medical devices
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Medical technology, etc. involving the use of unapproved or off-label in-vitro diagnostic reagents, where the impact on the human body from the use of such reagents is extremely small.
Advanced Medical Care B
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Medical technology involving the use of unapproved or off-label drugs or medical devices
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Medical technology that does not involve the use of unapproved or off-label drugs or medical devices, and that is deemed to require particularly intensive observation and evaluation of the implementation environment, effects of the technology, etc., in consideration of the safety and effectiveness of the medical technology.
The currently approved advanced medical treatments at our hospital are as follows:
| Advanced medical technology name | Department of medical practice | Approval date | |
| Advanced Medical Care A | Fertilized egg and embryo culture using time-lapse imaging | Obstetrics and Gynecology | Approved in November 2024 |
Physiological Sperm Selection with Hyaluronic Acid (PICSI) |
Obstetrics and Gynecology |
Approved in June 2025 |
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| Advanced Medical Care B | Laparoscopic sentinel lymph node biopsy | Gastroenterological Surgery | Approved in September 2018 |
| Postoperative combination therapy with oral capecitabine and intravenous oxaliplatin | Gastroenterology | Approved in May 2018 | |
| Cartilage regeneration treatment using autologous chondrocyte sheets Knee osteoarthritis (limited to cases with cartilage defects and suitable for high tibial osteotomy) | Orthopaedic Surgery | Approved in April 2019 | |
| Intravenous tenecteplase therapy | Department of Neurology | Approved in September 2022 | |
| Localized cauterization and coagulation therapy for prostate cancer using a focused ultrasound device. Prostate cancer (limited to localized cases). | Department of Urology | Approved in February 2023 |
Overview of advanced medical treatments available at our hospital
Advanced Medical Care A
| Advanced Medical Care Technical name |
Fertilized egg and embryo culture using time-lapse imaging |
| Department of medical practice | Obstetrics and Gynecology |
| Approval date | November 1, 2024 |
| Indications | Infertility requiring embryo transfer |
| Technology Overview | The time-lapse incubator (TI) used in time-lapse imaging is equipped with a high-performance camera inside the incubator, which can continuously capture images of embryos at regular intervals of 5 to 15 minutes. This allows embryologists to evaluate the condition of the fertilized eggs and embryos via computer without removing them from the incubator. By not removing the embryos from the incubator, a stable environment is always maintained, and it has been reported that this method improves culture results (blastocyst development rate) compared to conventional culture methods. Furthermore, the embryo development process is recorded on video, making it easier to identify abnormal fertilization or cleavage. |
| Advanced Medical Care Technical name |
Physiological Sperm Selection with Hyaluronic Acid (PICSI) |
| Department of medical practice | Obstetrics and Gynecology |
| Approval date | June 1, 2025 |
| Indications | Patients who have experienced repeated miscarriages or implantation failure after ICSI, or who have repeatedly experienced poor embryo development |
| Technology Overview | In conventional ICSI, embryologists visually check the sperm morphology and motility, and select the best sperm for use. Physiological sperm selection using hyaluronic acid utilizes the ability of normal mature sperm to bind to hyaluronic acid, allowing for the selection of sperm with minimal DNA or chromosomal abnormalities for ICSI. This is expected to improve fertilization and clinical pregnancy rates. |
Advanced Medical Care B
| Advanced Medical Care Technical name |
Laparoscopic sentinel lymph node biopsy |
| Department of medical practice | Gastroenterological Surgery |
| Approval date | September 1, 2018 |
| Indications | Early stomach cancer |
| Technology Overview | This phase II, multicenter, single-arm study evaluated the curability and safety of "individualized surgery using SN as an indicator of LN metastasis" in patients with solitary early gastric cancer diagnosed preoperatively as T1N0M0 and tumors measuring 4 cm or less in longitudinal axis. All patients underwent SN biopsy, and if SN metastasis was negative during surgery, they were classified as the "reduced surgery group" (Group A) by performing a reduced gastrectomy (proximal gastrectomy, pylorus-preserving gastrectomy, partial gastrectomy, or segmental gastrectomy) based on SN basin resection as the general rule. If the extent of basin resection made reduced surgery difficult, a conventional gastrectomy (proximal gastrectomy or total gastrectomy) (Group B) was performed. In addition, if SN metastasis was positive, D2LN dissection and conventional gastrectomy (proximal gastrectomy or total gastrectomy) (Group C) was performed. The primary endpoint was 5-year recurrence-free survival rate, and secondary endpoints were SN identification rate, metastasis detection sensitivity, 3-year recurrence-free survival rate, 3-year and 5-year overall survival rate, and postoperative quality of life. The primary endpoint, i.e., evaluation of the curability and safety of personalized surgery, will be achieved by comparing the surgical outcomes of groups A to C (personalized surgery group) enrolled in this study with previously reported surgical outcomes for the same early gastric cancer, and the prognosis of a subset of group A alone will also be verified as a secondary endpoint. Postoperative QOL will also be compared within the "personalized surgery group." |
| Advanced Medical Care Technical name |
Postoperative combination therapy with oral capecitabine and intravenous oxaliplatin |
| Department of medical practice | Gastroenterology |
| Approval date | May 1, 2018 |
| Indications | Small intestinal adenocarcinoma (limited to those in stage I, II, or III that have been determined to have been completely resected based on macroscopic and pathological observations). |
| Technology Overview | To determine whether the relapse-free survival (RFS) period of postoperative chemotherapy is superior to that of surgery alone in patients with pathological Stage I/II/III small intestinal adenocarcinoma after curative resection. |
| Advanced Medical Care Technical name |
Cartilage regeneration treatment using autologous chondrocyte sheets Knee osteoarthritis (limited to cases with cartilage defects and suitable for high tibial osteotomy) |
| Department of medical practice | Orthopaedic Surgery |
| Approval date | April 1, 2019 |
| Indications | Knee osteoarthritis (limited to cases with cartilage defects that are suitable for high tibial osteotomy) |
| Technology Overview | This technology is a treatment for cartilage defects in patients with osteoarthritis of the knee (patients indicated for high tibial osteotomy). (1) After primary enrollment, arthroscopy confirms eligibility criteria for area and grade of cartilage defects. (2) Secondary enrollment of subjects who meet the criteria in (1) above, and collection of the patient's own cartilage and synovial tissue from the unloaded femoral side of the knee joint, which is necessary for the preparation of cartilage cell sheets. (3) Collected tissue is transported from Tokai University Hospital to CellSeed CPC, cells are isolated, and after a 3-4 week culture period, cartilage cell sheets are produced and transported to Tokai University Medical Center on the day of surgery. (iv) Treatment of cartilage defects in osteoarthritis of the knee by RMSC technique* in conjunction with high tibial osteotomy. (5) Periodically check the repair of cartilage defects according to the inspection schedule. (*) RMSC method Resection of unhealthy tissue Marrow Stimulating (MSCs Recruitment) Covered by Chondrocyte sheets |
| Advanced Medical Care Technical name |
Intravenous tenecteplase therapy |
| Department of medical practice | Department of Neurology |
| Approval date | September 1, 2022 |
| Indications | Cerebral infarction within 4.5 hours of onset |
| Technology Overview | This study aims to establish the efficacy and safety of the thrombolytic agent tenecteplase for acute cerebral infarction. Specifically, the safety of tenecteplase (presence or absence of symptomatic intracranial hemorrhage and coagulation-fibrinolysis markers) will be confirmed in a small number of patients with acute cerebral infarction due to major cerebral artery occlusion within 4.5 hours of onset (safety evaluation phase). Subsequently, the efficacy (effectiveness of recanalizing major cerebral artery occlusion) and safety will be examined in an unmasked, randomized, parallel-group comparative study using alteplase as a control to demonstrate the superiority of tenecteplase over alteplase in achieving successful early vascular recanalization after initiation of study drug treatment. Primary endpoints are the proportion of patients with successful recanalization or no retrieval-required thrombus on initial angiography after initiation of treatment, the incidence of symptomatic intracranial hemorrhage within 24-36 hours after initiation of treatment, and all-cause mortality at 90 days. Secondary endpoints were the proportion of patients with dramatic improvement in neurological symptoms 72 hours after the start of administration, the modified Rankin Scale (mRS, shift analysis) 90 days after administration, the proportion of patients with mRS 0-1 or no change from pre-morbid mRS 90 days after administration, and the proportion of patients with mRS 0-2 or no change from pre-morbid mRS 90 days after administration. |
| Advanced Medical Care Technical name |
Localized cauterization and coagulation therapy for prostate cancer using a focused ultrasound device. Prostate cancer (limited to localized cases). |
| Department of medical practice | Department of Urology |
| Approval date | February 1, 2023 |
| Indications | A case of localized prostate cancer in which cancer localization within the prostate was diagnosed by MRI-transrectal ultrasound fusion image-guided targeted prostate biopsy and systematic transperineal 12-site biopsy |
| Technology Overview | This localized therapy is performed based on MRI-transrectal ultrasound fusion image-guided targeted prostate biopsy and a systematic 12-point transperineal biopsy. This medical device allows for flexible configuration of the treatment area, clearly distinguishing between treated and non-treated areas within a few millimeters. Furthermore, high-power ultrasound heats the treatment area, causing thermocoagulation necrosis. Because high-power ultrasound heats only the focal area to 70-100°C, it can treat prostate cancer without damaging intervening tissue. This treatment preserves the urethra and neurovascular bundle, significantly preserving urinary function compared with radical treatments such as surgery or radiation therapy for the entire prostate. 1 It also minimizes sexual complications and allows for a short hospital stay, making it a treatment method that prioritizes patient quality of life. Furthermore, it can be performed repeatedly and requires only a short hospital stay. |