Greetings
The diseases we treat involve organ damage deep within the thoracic cavity, a chamber known as the rigid thoracic cage (the area surrounded by the ribs, sternum, spine, etc.). For this reason, even the smallest lesions required surgery, requiring surgeons to penetrate the rigid thoracic cage and reach the chest. This necessitated large incisions to reach the diseased area. One solution to this situation was the introduction of thoracoscopic techniques into therapeutic surgery. Thanks to the support of Tokai University's innovative environment and staff, and most importantly, the enthusiastic support of patients and their families, we have developed technology we believe is essential for patients. There is no set surgical technique that is always satisfactory. This requires constant effort from thoracic surgeons. Our department strives to provide patients with superior surgical techniques that will improve their quality of life.
Chief of Thoracic Surgery
Masayuki Iwasaki
Director of Thoracic Surgery Department
Ryota Masuda
Treatment details
The Department of Thoracic Surgery deals with surgical diseases of the chest, including the lungs, mediastinum, pleura, and chest wall. With the aim of reducing surgical invasiveness, we have actively adopted video-assisted thoracoscopic surgery (VATS), which uses small surgical incisions, for small lung cancers, spontaneous pneumothorax, and mediastinal tumors.
video assisted thoracoscopic surgery (VATS)
In 1994, we developed the two-window method, which allows surgery through only two small skin incisions, and more recently the one-window & one-puncture method, which allows surgery through only one incision. Compared to the traditional open chest incision, this method is far superior in terms of cosmetic appearance, as well as in terms of surgical time, intraoperative blood loss, postoperative pain, and recovery of respiratory function. This has made it possible for patients who were not suitable for traditional surgical methods, such as those with complications, those with low pulmonary function, the elderly, and children, to undergo surgery safely.
robotic assisted thoracoscopic surgery (RATS)
We introduced robotic-assisted surgery in December 2021. Surgery using the da Vinci Xi endoscopic surgical robot has been reported to be superior to open thoracotomy in terms of wound cosmetic results and reduction of postoperative intercostal neuralgia. Conventional robotic-assisted thoracoscopic surgery approaches for lung malignant tumor surgery require approximately five port holes, which tends to increase the number of incisions compared to thoracoscopic surgery. Applying our experience in reduced-hole surgery, a specialty of our department, we aim to perform robotic-assisted surgery with less trauma by using an approach that combines a two-finger-width window and one or two 8mm ports.
Main target diseases
Primary lung cancer, metastatic lung tumor, mediastinal tumor, pneumothorax, pleural tumor (including malignant pleural mesothelioma), pectus excavatum, chest trauma, emphysema (lung volume reduction surgery), palmar hyperhidrosis (thoracic sympathectomy), etc.
Main medical achievements
The total number of Thoracic Surgery procedures over the nine years from January 2014 to December 2023 was 3,326, with the number of procedures showing an increasing trend in recent years. Of these, 2,451 (74%) were thoracoscopic surgeries. The 30-day postoperative mortality rate was 0.1%. The number of surgeries for representative diseases during this period is as follows:
Primary lung cancer
We performed 1,600 surgeries (an average of 178 per year). Of these, 1,307 (82%) were thoracoscopic surgeries. We also perform approximately 40 robot-assisted thoracoscopic surgeries for primary lung cancer per year. By surgical procedure, there were 1,312 lobectomies (including bilobectomies), 56 segmentectomies, and 207 partial resections.
metastatic lung tumors
A total of 320 surgeries were performed, of which 293 (92%) were thoracoscopic surgeries.
Mediastinal tumors
A total of 390 surgeries were performed, including 183 cases of thymic epithelial tumors (thymoma, thymic carcinoma, etc.). In recent years, the proportion of thoracoscopic surgeries and robot-assisted thoracoscopic surgeries has been increasing, with 63% (30 cases) of surgeries performed using thoracoscopic surgery and 32% (13 cases) of surgeries performed using the Da Vinci system in 2023.
Spontaneous pneumothorax
We performed surgery on 377 cases. All surgeries for spontaneous pneumothorax were performed using a thoracoscopic procedure, and most patients were able to return to work after just two days of hospitalization after surgery.
funnel chest
We performed this surgery on 56 patients. A titanium alloy bar is inserted into the chest cavity from the lateral chest and the cavity is elevated. This is a minimally invasive procedure that can be performed with only a small surgical incision of about 1-2 cm and without cutting any bone.
chest trauma
We have performed surgery on 23 patients. We also use thoracoscopic surgery for trauma surgery depending on the case, and we are making efforts to help with postoperative recovery.
Doctor List
Department Head: Ryota Masuda
Assistant Chief Physician of Ward 9A: Naohiro Ariga
Clinical department URL: https://www.fuzoku-hosp.tokai.ac.jp/service/kokyuu-geka/
http://lung.med.u-tokai.ac.jp/
Outpatient: 0463 (93) 1121 extension 6201, 6202
Professor Masayuki Iwazaki
| Specialization | General Thoracic Surgery |
|---|---|
| Specialist | Japan Surgical Society Supervising Doctor/Specialist / Japanese Society Thoracic Surgery Supervising Doctor/Specialist / Interim Cancer Treatment Educator |
| Specialized Areas | Lung cancer, thoracoscopic surgery, emphysema, pediatric Thoracic Surgery (funnel chest) |
| Outpatient medical day | Monday |
Professor Ryota Masuda
| Specialization | General Thoracic Surgery |
|---|---|
| Specialist | Japan Surgical Society Supervisor and Specialist / Japanese Society Thoracic Surgery Specialist |
| Specialized Areas | Lung cancer, mediastinal tumors, pleural tumors (mesothelioma) |
| Outpatient medical day | Wednesday |
Lecturer: Naohiro Aruga
| Specialization | General Thoracic Surgery |
|---|---|
| Specialist | Specialist of the Japan Surgical Society/Specialist of the Japanese Society Thoracic Surgery |
| Specialized Areas | Lung cancer, pneumothorax |
| Outpatient medical day | Friday |
Lecturer Tomohiko Matsuzaki
| Specialization | General Thoracic Surgery |
|---|---|
| Specialist | Specialist of the Japan Surgical Society/Specialist of the Japanese Society Thoracic Surgery |
| Specialized Areas | Lung cancer, pneumothorax |
| Outpatient medical day | Thursday |
Assistant Professor Atsushi Wada
| Specialization | General Thoracic Surgery |
|---|---|
| Specialized Areas | Lung cancer, pneumothorax |
| Outpatient medical day | Tuesdays, Thursdays |
Assistant Professor Hiroto Onozawa
| Specialization | General Thoracic Surgery |
|---|---|
| Specialist | Japan Surgical Society Specialist |
| Specialized Areas | Lung cancer, pneumothorax |
| Outpatient medical day | Tuesday and Friday |
Assistant Professor Kei Nakano
| Specialization | General Thoracic Surgery |
|---|---|
| Specialized Areas | Lung cancer, pneumothorax |
| Outpatient medical day | Monday |