Gynecological Surgery

We place emphasis on minimally invasive surgery for benign conditions using laparoscopy and hysteroscopy, which generally involves less post-operative pain, a faster recovery, and a shorter hospital stay, supporting an earlier return to daily life. Where a minimally invasive approach is not suitable, or in an emergency, open surgery is also available.

Laparoscopic surgery

This approach uses small incisions in the lower abdomen to insert a laparoscope. We perform roughly 70 such procedures a year (April 2023 to March 2024).

Covered under Japan's high-cost medical care programme.

Advantages

• A smaller incision generally means less post-operative pain.
• Recovery tends to be faster, supporting an earlier return to daily life.
• Scarring is generally less noticeable.
• Post-operative adhesion, a risk factor for fertility, tends to be reduced.

Considerations

• Not suitable for every case, depending on the size or number of growths.
• Specialised equipment means this is not available for urgent overnight surgery.
• Carries specific risks of its own (subcutaneous emphysema, compartment syndrome).
• If significant adhesion is found once surgery has begun, conversion to open surgery may be necessary.

A physician certified in laparoscopic technique by the Japan Society of Obstetric and Gynecologic Endoscopy is on our staff.

Conditions treated

We perform laparoscopic surgery for benign tumours only. Where uterine fibroids, ovarian cysts, or hydrosalpinx are found and fertility is a concern, we coordinate with a nearby fertility clinic; please ask your outpatient physician for details.

• Ovarian cysts
• Uterine fibroids
• Uterine prolapse
• Ectopic pregnancy

Hysteroscopic surgery

This approach inserts an endoscope through the cervix to remove growths projecting into the uterine cavity, such as submucosal fibroids or endometrial polyps. We perform many of these procedures with fertility in mind.

Covered under Japan's high-cost medical care programme.

Advantages

• No abdominal scarring.
• Very little pain, supporting an early return to daily life.
• Lower risk of adhesion, so a lower associated risk of tubal or bowel obstruction or fertility difficulty.
• Performed under direct monitor visualisation, supporting careful attention to safety.

Considerations

• There is a limit to the size of growth that can be removed this way.
• Uterine infection can occasionally occur.
• If unexpected bleeding or another complication arises, laparoscopy or open surgery may be needed to assess the situation.
• For conditions with a range of underlying causes, symptoms may not fully resolve in every case.

A physician certified in hysteroscopic technique by the Japan Society of Obstetric and Gynecologic Endoscopy is on our staff.

Conditions treated

• Endometrial polyps
• Submucosal fibroids, and similar conditions

We aim to reduce the burden on patients through day-case admission where possible.

Open surgery

Where laparoscopic or hysteroscopic surgery is not suitable, or a complication arises during minimally invasive surgery, or urgent overnight surgery is needed, we perform open surgery. Post-operative pain management is handled by our anaesthesiology department.

Covered under Japan's high-cost medical care programme.

Advantages

• Even a small fibroid can be removed.
• Possible even where adhesion is present.
• The uterine wall can be sutured thoroughly, supporting confidence in a future pregnancy.
• This hospital generally uses a horizontal incision, so the scar is hidden beneath underwear and is not very noticeable.

Considerations

• Leaves a visible scar on the abdomen.
• Post-operative pain.
• A risk of complications such as bowel obstruction.

Conditions treated

Mainly uterine fibroids that are numerous or large.

Surgical volumes (2020-2024, laparoscopic)