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Gynecologic Surgery

Gynecologic Surgery

Specialists at the Department of Gynecologic Surgery provide accurate diagnoses of benign and malignant tumors of the female genital organs (uterus, ovary, etc.) and appropriate surgical and nonsurgical treatments. Infertility, genital organ malformation, genital organ prolapse and other dysfunctions and morphological abnormalities are also treated surgically.

Medical services

About 1,000 patients are admitted for treatment annually to our department and more than 15 surgeries are performed weekly. In addition, chemotherapy and radiotherapy are provided for malignant tumors. The outpatient clinic is staffed with specialists in a variety of fields.

Diagnosis and treatment policy

Our aim is to provide optimal treatment for individual patients based on established evidence and detailed discussion among many physicians. Case review meetings in which all doctors participate and joint review meetings with relevant departments are regularly held to determine treatment strategies based on comprehensive understanding.

Specialties

An interdisciplinary treatment approach is taken which utilizes a combination of surgical treatment, chemotherapy and radiotherapy in the majority of cases involving malignant tumors in the uterus and organs attached to the uterus (ovaries, oviducts). Through this approach, favorable outcomes have been achieved. Minimally-invasive, safe, laparoscopic surgery is frequently employed in the treatment of benign tumors and genital organ malformation. Bone densitometry is also applied in maintaining and improving the quality of life in menopausal women and patients who have undergone treatment for tumors.

Target diseases

Cervical cancer, endometrial cancer, ovarian cancer, trophoblastic disease, other malignant female genital tumors, hysteromyoma, adenomyosis, ovarian cyst, endometriosis, ectopic pregnancy, malformation of uterus and other female genital organs, uterine prolapse, infertility requiring surgery, etc.

Advanced treatments/ Specialized treatments

Radical trachelectomy for women of childbearing age with early cervical cancer

In our department, we perform radical trachelectomy (a surgical procedure including removal of uterine cervix, paracervical tissue and pelvic lymph nodes, and preserving uterine corpus and ovaries) for patients of reproductive age with stage IB1 cervical cancer (in principle, age of less than or around 40, less than 2cm of tumor diameter). In case that the tumor extension proves to be wider (e.g. lymph nodes positive for cancer) during the operation, the surgery will be switched to radical hysterectomy.

Laparoscopic sacralcolpopexy (LSC) for pelvic organ prolapse (POP)

Parity significantly affects the development of pelvic organ prolapse, a disease known to worsens QOL of elderly people. Currently, LSC, first reported in 1998, is widely accepted as a standard operation for POP all over the world, and LSC is now performed as a first-line operation for POP in this hospital since 2013.

Adenomyomectomy

Adenomyosis, a benign gynecological disease defined by the presence of endometrium-like tissue within the myometrium, causes severe abdominal pain and heavy bleeding during menstruation. Although the recommended surgical treatment for symptomatic adenomyosis is hysterectomy, our department performs adenomyomectomy (resection of adenomyosis lesion) for patients wishing to preserve their fertility and improve their symptoms.

Frequently performed tests

  • Pathological tests on the uterine cervix and endometrium
  • Colposcopy
  • Uterosalpingography
  • Hysteroscopy
  • Bone densitometry (DXA)
Yutaka Osuga

Yutaka Osuga

Departments/Divisions

Gynecologic Surgery

Titles

Professor

Expertise/Specialties

Reproductive medicine, laparoscopic surgery, assisted reproductive technology

Research Interests

Pathogenesis and management of endometriosis, Ovarian physiology/ pathology

Languages

Japanese / English

See More

Major diseases treated in this department

Disease name Number of patients
1 Malignant uterine tumors (cervical: 71; endometrial: 86) 157
2 Malignant ovarian tumors 57
3 Other malignant tumors(Peritoneal cancer:3,Vaginal Cancer:1) 4
4 Uterine fibroids and adenomyosis 235
5 Benign ovarian tumors 214
6 Ectopic pregnancy 13
7 Endometrial polyps 36
8 Pelvic organ prolapse 27
9 Chorionic disease ( invasive hydatidiform mole;1, total hydatidiform mole;2) 3

(2015)

Areas of expertise, treatment and examination methods

Diseases
  1. General malignancy tumors, such as cervical, endometrial, and ovarian cancer
  2. General benign diseases, such as endometriosis, uterine fibroids, ovarian cysts,adenomyosis of uterus and pelvic organ prolapse
Treatment methods
  1. Multidisciplinary treatment of malignancy tumors, combining surgical procedures, chemo- and radiotherapies and fertility-sparing surgery
  2. Endoscopic surgery for benign diseases and pharmacotherapy and surgical therapy for endometriosis
Examination methods
  1. Diagnostic imaging of tumors
  2. Pathological diagnosis of tumors
  3. Bone density measurement using DXA

Numbers of major operations and treatments performed

Name of operation/treatment Number
1 Radical and modified radical hysterectomy 45
2 Ovarian cancer surgery excluding borderline malignant cases 38
3 Uterus-conserving surgery for cervical cancer 10
4 Laser surgery for tumors, such as cervical cancer 99
5 Simple hysterectomy for malignant uterine tumors 23
6 Pelvic lymph node dissection 100
7 Para-aortic lymph node dissection 52
8 Laparoscopic total hysterectomy for malignant tumors of the uterus (with pelvic lymphnode dissection; 11) 26
9 Hysteroscopic surgery 12

(2015)

Numbers of operations for benign diseases

1 Laparoscopic Oophorocystectomy 100
2 Laparoscopic fibroidectomy (Uterus preserving) 57
3 Laparoscopic adnexectomy 81
4 Laparoscopic panhysterectomy 44
5 Laparoscopic ectopic pregnancy surgery 12
6 Laparoscopic Sacrocolpopexy; LSC 20
7 Hysteroscopic myomectomy 29
8 Hysteroscopic polytectomy surgery 36
9 Open total hysterectomy 48
10 Enucleatic myomectomy (open) 29
11 Oophorectomy(open) 15

(2015)

Numbers of major and specialized examinations conducted in this department

Name of examination Number
1 Hysteroscopy approx. 200
2 Uterosalpingography approx. 150
3 Colposcopy approx. 1,800

(2015)

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