Digestive Diseases Center, Showa University Koto Toyosu Hospital

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International Doctors’ Experiences

Robert Bechara, MD

Country Canada
Institution School of Medicine, Queen’s University
Term September 2014 – October 2015

I was able to watch and participate in over 300 POEM procedures. Then with the hands-on portion of my training I was able to perform over 30 POEM procedures and during this time I was able to also advance my knowledge of the procedure in addition to develop the motor skills to successfully and safety perform the procedure. I was also able to learn other practical aspects of the POEM procedure which include equipment setup and troubleshooting as well as clinical management pre/post procedure. During my stay I was also extremely lucky to also observe and assist in the ARMS procedure. I was able to watch about 30 procedures. I was very lucky to be able to join the first joint POEM+ARMS conference and present on endoscopic treatment of GERD.

Valerio Balassone, MD

Country Italy
Institution Tor Vergata University of Rome
Term July 2015- February 2016

During my 8-month stay at Showa University Koto Toyosu Hospital, I observed/assisted over 140 POEMs and performed 15 POEMs. I was also able to observe/assist 40 ESD (pharynx, esophagus, stomach, duodenum, colon), observe over 15 ARMS, other laparoscopic procedures, colonoscopy, colon ESD and EMR. I was also able to participate in clinical conferences and seminaries.

Joshua Tuason, MD

Country Philippines
Institution Cebu Doctors’ University Hospital
Term May 2016 – May 2017

I have had the pleasure of training and learning under the guidance of the world leaders in Peroral endoscopic myotomy (POEM), and other advanced therapeutic endoscopic techniques. Prof. Haruhiro Inoue, and Dr. Haruo Ikeda have overseen my progress, and I have become confident in my newly acquired knowledge and techniques as well. During my 1 year stay in Japan, I have assisted well over 100 cases of POEM. I have performed 30 cases of POEM. I have observed and assisted several cases of Endoscopic Submucosal Dissection, Anti-Reflux Mucosectomy, Per Oral Endoscopic Tumor Resection, Laparoscopic Fundoplication, Esophagectomies, and Laparoscopic Gastrectomies. I was able to attend 3 international conferences during my stay here: The inaugural Tokyo Endoscopy Live in 2016, Yokohama Live 2017, as well as Tokyo Endoscopy Live 2017. I was part of the working staff for Tokyo Live 2017.

Michelle Katherina Savu, MD

Country USA
Institution Veteran Affairs South Healthcare Center, University of Texas Health Science Center
Term February 2017 – July 2017

During my 5-month stay I observed or participated in 54 POEM procedures, 2 POET procedures and multiple ESD and EMR procedures. I was able to perform 7 POEM procedures under proctoring. I have submitted one abstract for a national American meeting (SAGES) and await the results. I attended one Tokyo LIVE conference during my stay. I was very impressed with the expertise of the surgeons and gastroenterologists at Showa University. Their dedication, knowledge and experience were exceptional. My learning during my time at Showa, as an experienced surgeon and basic endoscopist, brought my knowledge of disease and my technical abilities to a much higher level than before my time in Japan. While at Showa I was extremely impressed by Professor Inoue and his team of surgeons and GI physicians’ thoroughness of evaluation for the patients and their technical skill expertise. Professor Inoue and his team should be very proud of their accomplishments and treatment for their patients. My time at Showa was invaluable and for this I am very thankful both personally and professionally.

Arthur Belkov, MD

Country Russia
Institution Branch of Federal Budgetary Healthcare Institution, Clinical Rehabilitation Center of Ministry Economic Development of Russia
Term July 23, 2017 – August 10, 2017

I wanted to thank the Professor Inoue-sensei and members of the endoscopic department for the warm welcome and intensive, useful studies. The knowledges gained during my studies will significantly improve the quality of my work. Experience acquired during masterly performed operations will add confidence in operational endoscopy. I wanted to note the high professionalism of the professor and the staff of the endoscopy department. The organization of the endoscopic department also deserves the highest appreciation, the passage of studies on the basis of this department was as informative and comfortable as possible. Once again, I wanted to thank you for the unforgettable educational process. Looking to the future with the hope of visiting again Showa University Hospital.

Ashish Sharma, MD, PhD

Country USA
Institution Kaiser Permanente Hospital
Term April 2017 – July 2018

I spent over a year conducting research under the guidance of Professor Inoue at Showa University. This gave me a unique opportunity to learn and practice techniques that were developed in Japan. The hands-on approach also provided valuable practical information about the intricate aspects of these techniques. While the POEM technique was developed by Prof. Inoue, a newer technique called POEM+ F [fundoplication] has been recently developed and a human trial is ongoing with good results. It has been submitted to the journal of Endoscopy in Europe.

Anastasios Manolakis, MD, PhD

Country Greece
Institution University Hospital of Larissa
Term January 2018 – January 2019

During the past 12 months I was exposed to the full spectrum of procedures performed for diagnostic and therapeutic purposes at DDC, Showa Toyosu Hospital, under the supervision and guidance of Professor Haruhiro Inoue. In the field of interventional endoscopy, I received dedicated training in POEM, ARMS, ESD, Per Oral Endoscopic Tumor resection (POET), cap-assisted EMR (capEMR) and was given the chance to perform numerous procedures in Japanese and overseas patients. The outcomes for patients were unanimously deemed favorable and the experience as well as skills that I gained and mastered, through this specialised training program, can be considered as outstanding/unique. Finally, during this period I had the chance to witness and be trained in novel procedures pioneered by Professor Inoue such as the Anti-Reflux Mucosal Ablation and POEM with endoscopic fundoplication (POEM+F).

Enrique Rodriguez de Santiago, MD, MSc

Country Spain
Institution Hospital Universitario Ramon y Cajal
Term July 2018 – November 2018

I have performed a 4-month International Observership programme at Showa Koto Toyosu University Hospital. I have been able to attend more than 100 live cases of POEM, more than 60 ESD cases and 5 cases of antireflux mucosal ablation. During my stay, I have acquired thorough theoretical knowledge and discovered a new way to perform endoscopy. Besides, I have received highly valuable tips from experience endoscopist that would be useful for my daily practice in my home country. I have received enough training to implement these techniques in my hospital, which was the main goal of my stay. From my perspective, I have fulfilled the objectives of my fellowship.

Bianca Maria Quarta Colosso, MD

Country Italy
Institution The University of Cagliari
Term April 2019 – December 2019

My experience can be summarized in 3 key points: observation, hands-on practice and research. Over 9 months of stay, I had the chance to observe more than 300 POEM procedure and also POET, diagnostic assessment of GI lesions, endocytoscopy, ESD, endoscopic sub-serosal dissection (ESSD), novel closure techniques like micro-ring, EPSIS (Endoscopic Pressure Study Integrated System), endoscopic treatment for esophago-gastric reflux disease such as anti-reflux mucosal ablation (ARMA) and the impressive per-oral endoscopic fundoplication (POEF) and per-oral endoscopic myotomy + fundoplication (POEM+F). Since my Japanese license was issued, I started the hands-on training for POEM, and until my last day I performed as first operator over 20 procedures.

2014-2015 International Fellows from Thailand, Philippines, USA and Canada

2014-2015 International Fellows with Prof. Haruhiro Inoue

Fellows from USA (2017-2018), Greece (2018-2019) and Philippines (2018-2019) with Prof. Haruhiro Inoue

2018 International Fellows (from Greece and Spain) and Short-term Observers (from Mongolia, Russia and United Kingdom)

2019 International Fellows (from Italy and Philippines) and Short-term Observers (from United Kingdom and Australia)

2019 International Fellows (from Italy and Philippines) and Short-term Observer from Portugal