Year : 2018 | Volume
: 3 | Issue : 1 | Page : 82--88
|How to cite this article:|
. Interview.Saudi J Laparosc 2018;3:82-88
|How to cite this URL:|
. Interview. Saudi J Laparosc [serial online] 2018 [cited 2019 Jul 17 ];3:82-88
Available from: http://www.saudijl.org/text.asp?2018/3/1/82/239272
Dr. Takahiro Kinoshita
Is this your first time visiting Saudi Arabia?
No, this is the second time.
When was the first time?
Six years ago, it was for a conference organized by Prof. Alzahrani at Intercontinental Hotel.
How's the conference so far?
It is great, there is difference in the culture, surgical strategies, and also, the patients are difference. It is very nice to share our experiences with you, and it is very beneficial for us.
What is your specialty?
My specialty is Gastric Cancer Surgery.
Would you recommend the students to enter Gastric Cancer Surgery?
I do not know if gastric cancer common in this country, maybe Japan has lots of experience regarding the treatment of gastric cancer, and Japan has all the guidelines and classifications; also, I believe Japan is now leading the gastric cancer treatment in the world. I hope medical students in Saudi Arabia become interested in gastric cancer surgery, and actually, our national gastric center accepts International trainers or fellowships. We will be happy to accept lots of young surgeons and medical doctors from Saudi Arabia.
What advice you would give to medical students?
Study hard and accumulate lots of knowledge and experiences.
What made you choose your specialty?
Gastric cancer is very common in Japan. Gastric cancer is considered to be number 1 cancer in Japan, and it is the third common cause of mortality. But, it is decreasing because the reason for this cancer is Helicobacter pylori infection and this infection is now decreasing.
How do you manage your time as a surgeon and a researcher?
It is very difficult from 8:30 am to 4:00 pm. I have to do surgeries. After that, I can do some research work or writing English articles about gastric cancer, and also, I have to review and correct articles written by my junior doctors at the weekends. I have to attend some conferences like Domestic Conferences and International Conferences. Every year, I attend conferences and workshops for around 20 times.
How do you stay motivated?
We are medical doctors, so we always treat the patient and talk with the patient family. Most of the patients are satisfied after the surgery, and the patient sends us appreciation cards; this is a motivation. Also, I am a father and seeing my children growing up, this is a motivation.
Dr. Masayuki Ohta
How is your visit so far?
It is good.
What did you do?
I like the food, I ate rice, and l like the climate here.
How is the conference so far?
I like the conference; the speakers are good.
You are specialized in esophageal gastric diseases and achalasia?
What made you choose this specialty?
My senior colleague told to enter it. She is my mentor, and it was a good decision.
What about surgery, why did you choose it?
Actually, I wanted to be a pilot, but I cannot because of my eyes; my friend was a gynecologist and told me to be a doctor.
What advice would you give it to medical students?
Be patience. I don't know how to say it in English, but if the patient has cancer, don't cure not only cancer but also look after the patient.
How do you manage your time as a surgeon?
I always work, and I do not have much time to do anything.
Dr. Hiroya Takeuchi
Is this your first time in Saudi Arabia?
Have you learned any Arabic words so far?
Are you enjoying the conference?
Which topic was your favorite?
I enjoyed esophageal cancer and gastric cancer.
What are the latest advances in upper GI surgery?
Robotic surgery and advanced laparoscopic surgery especially for advanced cases or patients who received neoadjuvant chemotherapy. So, robotic gastrectomy and advanced laparoscopic gastrectomy will be the next topic.
You enjoy it and you see it as the future target for the surgeons?
Yes, and also my field, in Japan, gastric cancer is very dominant, so we might consider minimizing the extent of gastrectomy, especially for elderly patients to retain the possibility to cure after gastrectomy.
If you can give one advice about the conference, what would it be?
The conference was very successful. I am very impressed, but, actually, especially yesterday, most of the speakers are Japanese; so if possible, I want to hear another speaker from your country. So, I want to discuss with gastric cancer surgeons in your country. So, next, if I have the chance to come again, I would like to discuss with them.
Dr. Masayuki Ohta
Welcome Dr. Otta, I want to ask you a few questions what experiences do you have from this trip to Saudi Arabia?
This the first time for me to visit Saudi Arabia and eating dates was very delicious and sweet.
Are you enjoying the conference?
Yes of course.
What is your favorite part?
My specialty is Bariatric Surgery and Hepatobiliary and Pancreatic Surgery, so it's my favorite.
How do you think bariatric surgery has changed since its start, comparison between past and today?
Previously, in Japan, many people did Vertical-banded gastroplasty, but now, nobody does this procedure and sleeve gastrectomy now the safe and feasible and effective.
What do you think the future of the Bariatric surgery is it going to grow and grow?
I think yes because still in Japan, bariatric surgery is seldom and infrequent because some physicians do not know about the knowledge and efficacy and safety of bariatric surgery and that's the problem.
The last question: If you could provide advice to Saudi surgeon according to bariatric surgery, what could be that advice?
It's a very difficult question because in Saudi Arabia, over 1000 cases are performed every year, but in Japan, only 300 cases per year, but now, we are thinking about procedure choice, sleeve gastrectomy or sleeve bypass.
In a Japanese obese patient with diabetes, so tomorrow, I'll show some tips about the predictive factors in each procedure choice.
Dr. Seigo Kitano
Hi, Good morning Dr. Kitano, How are you? I want to ask you a few questions, is that okay with you?
Okay, First of all, we want to welcome you in Saudi Arabia. Our first question is, is this the first time you visit Saudi Arabia?
No, this is the second time.
This is the second?
Yeah, the last one was last year, May 2017. I've been here as one of the delegates of the Japan Ministries, where Japan Ministry of Labor (Japan Ministry of Health Labor Ministry).
Okay. What experiences have you had during this trip in Saudi Arabia?
Yes, This time.
Well, this time, we have really come together with seven different doctors to participate in this meeting. We're invited by Prof. Abdullah Aldohayan. I know him very long time ago, nearly since 20 years, surgical part since Asian field, Asian Vision. We communicate with each other; then, he asked me to join to participate in this meeting with a group of Japanese surgeons, particularly gastro and bariatric surgeons this time. So, this is the very first time to participate officially in the Congress organized by the Saudi doctors here.
Okay. Have you learned any Arabic words so far?
Well, actually, I think the small point system is different, particularly our Congress being much huge, much larger. Normally, we have a national meeting like this. So, in a sense, really, I used to be a President of Japan Society of Gastroenterological Surgery. It was 21,000 members. Also, my Japan Surgery Society has 14,000 memberships. So, we gathered few thousands in the national meeting. But, this time, the Laparoscopic Surgery, also the small group, was more than 100 participants here?
Yeah, So, I think it's very much like our society, in these days, if our societies come shoulder to shoulder, even if it is smaller, but I think in the near future much more doctors will join.
Very nice. What drove you to specialize in upper GI surgery?
Oh, I used to be specialized in upper GI, gastric surgery so far, but when I was a Professor of Surgery in the Department of Surgery, I used to operate on many of them such as colon, gastric, pancreas liver, and esophagus, and some others. I do this as a Chairman of the Surgery Department, and I was trained in any kinds of surgeries. But, particularly, I'm the first to perform laparoscopic gastric surgery in the world in 1991, that's why many people call me a laprogastric surgeon.
Then, after that we have, Can you tell us more about you're winning the latest award in 2017?
Sadataka Tasaka Honorary Lecture – Collaboration of Surgeons and Gastroenterologists in the Development of Endoscopic Surgery, it was last year during “The World Congress of GI Endoscopy (ENDO2017)” which was held in Hyderabad, India. I have a lot of work on the development of endoscopy in Asia. Long time ago, actually, I've done many endoscopic surgeries, endoscopic Hunton Course all over Asia, actually more than 150 total interests in 15 years.
Yeah, particularly, in Asia, 25–30 courses were done until now. So maybe, they considered me some kind of contributor to support the bariatric sectorin Endoscopic and Laparoscopic Surgery and Endoscopy in Asia. That's why they gave me the award of Sadataka Tasaka. Sadataka Tasaka was one of the top physicians to develop endoscopy in Japan. He was the founder of Japan's Gastroenterological Endoscopy Society, both, a long time ago. So, I'm much honored to have this award.
That's nice. Can you shed light on how you manage your time as a surgeon, researcher, and President of Oita University?
Actually, 7 years ago, I was appointed as the rector of the University. So, I quit my job as a surgeon 6 years ago. So, I appointed my successor Dr. Inawata and he will do very well. Actually, I don't operate on the patient, but I organize many meetings the same as this and etc. That is why I always like to work together.
Having won multiple awards and achieved such as this high status, to this day, what achievements you are most proud of?
Actually, one of it was being the President of International Federation of Societies of Endoscopic Surgeons in Asia (IFSES) that's a group of Japan Endo Surgeon, Takatsumiya.
Actually, it is the International Federation of Endoscopic Surgeons that is a group of Japans Endoscopic Surgeons, Endoscopies, and Laparoscopic Surgeons of Asia and those are E.S. Europe and SAGES. South America, India, and China have something they owe the National Society of Japan International Federation. I used to be the person for the International Federation of Endoscopic Surgeons all over the world. Also, I'm very pleased to have the owner of one of the prestigious prizes from Japan side, and I think our Takatsumiya Award, it means the name of our superior. Yeah, they gave me some kind of prize.
Wow! This is the highest one?
Yeah, it is the highest one. This drives me to develop the endoscopic surgery in the world.
The last question, if you could give the readers one advice, what will it be?
Is this for SLS journal?
Oh, I see. I'm the one on the table right?
I think the other thing the journal or article in a journal is fully evaluated by different readers or the content is very much sophisticated. Also, the content is very good. So, read carefully and then, on the basis of the journal, I like to ask the reader, readers to go around the world, and then try to get new ideas, and also make friends with worse and train yourself.
Thank you so much for your time.
OK thank you.
Dr. Naoki Hiki
How are you Dr. Heki?
How are you, Thank you.
It is our pleasure to do an interview with you.
This is for ACLS Journal. We have to ask you a few questions. Is that okay with you?
Is this the first time visiting Saudi Arabia?
No! It was I think 6 years ago, I was here to present the data of the Laparoscopic Surgery.
OK. How was your stay so far in Saudi Arabia?
It's very nice. Very nice.
Did you find it a nice place to stay?
Yes, a nice place. I like it very much because last time, it was so nice to come here and people are so kind.
How are you enjoying the comfort so far?
Yes, I have so many topics to talk about. I think it's very nice to introduce our data, Asian data to you because the difference in fatty patient is very. I'm saying you have a lot of fatty patients with BMI more than 50. And for us, BMI of the forties considered a very fatty patient.
So, there's a variation in between?
But, I think principle of surgical skill and our techniques are the same and very similar. And I hope our information is informative and fruitful for you.
OK. What was your favorite part favorite part of this conference?
It's very difficult. It's almost all presentation was conducted by Japanese. So, the favorite part is very difficult, but so many audiences have very much interest about our presentation and so, many questions. And it's a very nice atmosphere.
Have you learned or tried to learn something new here in Riyadh?
Not yet, because I don't have any presentation from you, because we Japanese have presentations.
The next day will be our presentations.
I expect it.
What drove you to specialize in the practice and research of gastric surgery?
We have, I think, the highest number of gastric cancer patients in our institution. And that's why we conducted so many clinical trials. And we publish so many English papers in the highest 20 English journals. And I think this is our interest in clinical science.
How do you manage your time as a surgeon, researcher, and as a part of the editorial board and multiple
Yeah, it's very difficult because I have so many operative cases. Together with clinical trials. Also, I have journals. I think not only me, but also our staff, junior staff can read so many papers, and finally, we can also share ideas and enhanced our journals.
If you have an advice for our readers, our journal readers, what do we want to advise them?
For readers or researchers?
Readers and researchers.
Question is always beside the bed or bedside; a clinical question always exists in the bedside, and that's why you can make a good question from the bedside and then you can produce a very clinical paper. And if you find two very good critical people, you can stay always thinking about the patient and pick up their very good clinical question from these papers for your journal.
OK, thank you so much for your time.
Thank you. Thank you very much.
Dr. Kazunori Kasama
What drove you into general surgery?
Thank you very much for your question. I know you have taken me a long time back. How did I develop my interest in Surgery and what drives me interested in surgery was, as a matter of fact, the momentum in medical practice was more of a surgical activity? And I always find surgery very interesting and challenging, and whenever you do an intervention, you see an immediate result of your intervention that was the main drive of being very much interested in general surgery.
So, what are you most looking forward in this conference, this gathering?
Well, you know the conference is always a great chance to meet with experts worldwide and has all the new techniques and developments in your practice far earlier than appearing in literature and in medical books. And that gives you a chance as well to entertain the expertise from worldwide, better than reading a paper, in my point of view. And for sure, you know having the conference and getting the experience together from all around the world is a great chance for you to learn from.
What are your impressions so far about this conference and how did you enjoy it?
You know King Saud University Conferences are always great, and the thing is, they tend to gather expertise from worldwide. And this is always a great chance to get to join all that international expertise.
So, our next question is about your presentation that you give earlier, could you give us a small description of it?
The presentation I gave was on the association of gastro-reflux disease and sleeve gastrectomy. There have been several studies worldwide reporting high incidence of gastroesophageal reflux disease following a sleeve gastrectomy and that has not been extensively studied. But, with the experience lately, new literature came up, showing that the problem with this difference in the gastroesophageal reflux disease incidence; following sleeve gastrectomy is the different technique applied by many surgeons, and majority of surgeons do not follow a standardized technique in order to avoid the gastro-reflux disease in those patients. Therefore, reaching to a standardized technique, where we can identify what are the risk factors of gastro-reflux disease following sleeve gastrectomy and take care of it during the sleeve gastrectomy would, in my point of view, reduce the incidence of gastroesophageal reflux disease.
Our last question is where do you see general surgery going? Where's the future of general surgery?
You know ask me about General surgery versus subspecialties. I still find the place for general surgery; no doubt about this, but, I am more in favor of subspecialties. Gives the surgeon a chance to focus and when surgeons focus, you would expect them to produce a better outcome. And therefore, still, general surgery is practiced, you could call it general surgery, or you could call it acute surgery which is practiced nowadays, but they have a spectrum of disease they deal with, and most of the diseases of the system are always going to be subspecialties. So, if you ask me if I still in favor of general surgery versus subspecialty, I would say I'm in favor of subspecialty, but I don't mean to kill the general surgery specialty.
I'd like to add one more question if you don't mind, what would you give as an advice to us medical students or interns people who are interested in pursuing a career in general surgery?
I would say, first of all, once you finish your medical college, focus during the internship to practice the rotations as if you are going to that specialty you are rotating in, once you have completed your internship, then there are many factors you need to consider, first of all, your preference where you find yourself? Number two, where do you find the demand of a specialty. I am a surgeon and I do prefer speed for surgery but still very attractive medical career, which one should not ignore, but I think I wouldn't recommend to decide on any specialty before you complete your internship. Do the internship focus on these specialties as if it is your own future specialty and once you are done, find yourself very much interested.