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Department of General and Cardiothoracic Surgery, Kanazawa University Hospital

Conditions Treated
Valvular Disease, Aortic Aneurysms, Angina, Cardiac Infarction(Heart Attacks), Atrial Septal Defects, etc.

Treatment Methods (Robot-Assisted Cardiac Surgery, and Other Methods)

Open thoracic surgery (thoracotomy) is common in cardiac surgery. This approach, however, leaves a large surgical wound, and requires time to heal—usually 2 to 3 months before the patient returns to a fully normal life.

At our hospital, we perform robot-assisted surgery using the “da Vinci” Surgical System. In this procedure, an endoscope and robotic arms are inserted into the patient through three small holes 1-2 cm in diameter, and the surgery is performed using 3D imaging of the surgical site on a monitor. This system enables us to execute exceptionally high precision and to reach surgical sites that previously could not be reached using conventional methods. This minimally invasive surgery ensures that surgical wounds are small, bleeding is minimal, and bones are not severed, making it possible for patients to be discharged in 3 days (2 days at the shortest) and to return immediately to normal life. Over 10,000 robot-assisted coronary artery bypass surgeries are performed every year in the U.S. However, there are only a few hospitals in Asia with robot-assisted surgical capabilities, due to the high cost of the equipment required.

Robot-assisted surgery or other cardiac surgery where the patient is returned to normal life quickly after the operation includes off-pump coronary artery bypass (OPCAB) and awake surgery. Ordinary coronary artery bypass graft (CABG) surgeries are performed using a heart-lung machine while the heartbeat is temporarily stopped. However, the heart-lung machine is not used in OPCAB surgery.

OPCAB surgery is superior to CABG surgery because the patient’s postoperative recovery is quicker and the risk of cerebral infarction (stroke), which can be induced by heart-lung machine usage, is lower. Awake surgery is performed on a patient when general anesthesia is considered to risk complications such as pulmonary dysfunction and/or cerebrovascular disease. The patient, under local anesthesia, remains conscious during the cardiac surgery. However, both OPCAB and awake surgeries are technically demanding and there are only a few hospitals worldwide where these surgeries can be performed, including Europe and the U.S.

Features of Our Department

Our hospital is a prominent hospital in the Hokuriku District, with nearly 150 years of history and tradition. We are a core general hospital in the Kanazawa area, with clinical departments covering all medical specialties. Among them, we have many excellent physicians at the Department of General and Cardiothoracic Surgery who have done outstanding work in research and are highly skilled in their respective specialties. Successes and accomplishments in state-of-the-art cardiac surgery, including the development of robot-assisted and awake surgical procedures, as well as carrying out the world’s first totally endoscopic OPCAB, are products of the professionalism of the world famous Team WATANABE, directed by Dr. Go Watanabe, and of the highly specialized hospital staff supporting the team. Dr. Watanabe has repeatedly succeeded in pioneering cutting edge surgery procedures that place fewer burdens on the patient and thus enable the speedy return of the patient to normal life. His work is highly regarded overseas, and particularly in robot-assisted surgery, he has had excellent results in double-bypass surgeries, valvular disease, and atrial septal defects.

The cumulative number of surgeries he has performed are as follows: (1) robot-assisted surgeries, 109; (2) OPCAB, over 2,000; and (3) awake surgeries, 85. When compared to conventional surgical methods, his methods have contributed positively to patient quality of life. Dr. Watanabe’s performance on OPCAB alone (average operative mortality rate) is 0.45%. The average U.S. operative mortality rate (CABG using the heart-lung machine alone) is 2.3% and the average Japanese operative mortality rate (beating heart coronary artery bypass is the preferred type of surgery) is 1.3%. These results show that Dr. Watanabe’s surgery performances are significantly safer. All of his cardiac surgeries are OPCAB. His success rate in simultaneous valvular disease surgery and coronary artery bypass surgery is 99.5%, and he ranks among the top in the world in terms of not only the number of surgeries he performs but also treatment results.

Moreover, we are actively performing heart surgeries, including valvuloplasty, assisted by robotics (“da Vinci”); at present, Dr. Watanabe is the only doctor in Japan capable of this procedure.

Average Operative Mortality Rate for the U.S./Japan and Average Operative Mortality Rate for Team WATANABE: A Comparison (10-Year Period)

  Average Operative
Mortality Rate
in the U.S. *1
Average Operative
Mortality Rate
in Japan *2
Overall Performance:
3.0%
Team WATANABE
Overall Performance:
0.5%
Coronary Artery
Bypass Grafting
Alone
2.31%
(Surgeries Using
the Heart-Lung
Machine Exclusively)
1.30% 0.44%
Valve Surgery
Alone
3.75% 3.82%
(Including Valvular
Disease and CABG)
0.29%
Valve Surgery plus
Coronary Artery
Bypass Grafting
8.00% No Data 2.5%
Thoracic Aortic
Aneurysm
No Data 7.01% 0.53%

*1 The Society of Thoracic Surgeons. Adult Cardiac Surgery Database (10 years STS Period Ending 09/30/2009)

*2 Data obtained from questionnaire survey conducted by the Japanese Association for Thoracic Surgery on approximately 60,000 surgeries performed during 2008, ” Thoracic and cardiovascular surgery in Japan during 2008” (DOI : 10.1007/s11748-010-0604-0)

A Message to International Patients from Dr. Go Watanabe at Our Department

We have been accepting patients from the U.S., China, Brazil, and other countries and we believe that robot-assisted surgery, the least invasive surgery, is our life’s work. Heart surgeries in Japan in general have shown great treatment results on an international level, and we have proven the technically demanding OPCAB to be the prevailing procedure in Japanese cardiac surgery. Among the world’s best, Team WATANABE aims to further improve treatment results as a leader in Japan among departments of coronary artery surgery and valvuloplasty, with the help of robotics.

PROFILE

Dr. Go Watanabe
Dr. Go Watanabe

Dr. Go Watanabe is Professor in the Department of General and Cardiothoracic Surgery.
Kanazawa University Hospital.
He also serves as chairperson of the board of directors at the Japan Robotic Surgery Society, deputy director of Associação Brasil-Japão de Pesquisadores (SBPN), as a cardiovascular surgery specialist and supervisory doctor at the Japanese Association for Thoracic Surgery.
Dr. Watanabe graduated from Kanazawa University School of Medicine and studied at Hannover Medical School as a clinician and experienced over 2,000 cases of cardiac surgery in two and one-half years.
He became the youngest Japanese surgeon to perform heart transplant surgery at the age of 32.
After returning to Japan, he was appointed professor (his current position) when he was 41.
He has also served as Visiting Professor at the International University of Health and Welfare since July 2011.

  • Watanabe G, et al. Beating-heart endoscopic coronary artery surgery. Lancet. 1999; 354: 2131-2.

Overview of the Treatment Schedule (Model Case: Robot-Assisted Coronary Artery Bypass Surgery)

Inquiries by e-mail are accepted.

Overview of Treatment Schedule

Photos

Dr. Go Watanabe’s Official Website Surgical Assist Robot “da Vinci” Robot-Assisted Surgery Using “da Vinci” Patient Room (Suite)
Dr. Go Watanabe’ s Official Website
http://www.doctorblackjack.net/index.html
Surgical Assist Robot “da Vinci” Robot-Assisted Surgery Using “da Vinci” Patient Room (Suite)
Hospital Contact Information
International Medical Affairs Office
Email: surg-hp@med.kanazawa-u.ac.jp
Established 1862
(Kanazawa Igakukan, the predecessor of the present School of Medicine, was established in 1870)
Clinical Departments
Cardiovascular Surgery, Endocrinology/General Surgery, Respiratory Surgery
Payment Methods
VISA and Debit Card are accepted

map

Address
13-1 Takara-machi, Kanazawa-shi, Ishikawa 920-8641
Approximately 20−30 minutes from JR Kanazawa Station by bus
Approximately 15−20 minutes from JR Kanazawa Station by Car
40−50 minutes from Komatsu Airport by car
URL
http://www.kanazawaheart.jp/index.html