Advanced Treatment for Prostate Cancer
Reducing Burden with Robotic Surgery

For prostate cancer, robotic-assisted surgery using the Da Vinci system reduces the risk of bleeding and complications. Radiation therapy can also be combined to aim for early recovery.

Providing Medical Institution

Kishiwada Tokushukai Hospital

〒596-0042
4-27-1 Kamoricho, Kishiwada City

https://kishiwada.tokushukai.or.jp/en/

Specialty

**Cardiovascular Surgery:**
1. Coronary Artery Disease
2. Heart Valve Disease
3. Aortic Aneurysm
4. Aortic Dissection
5. Arteriosclerosis Obliterans
6. Arterial Thrombosis
7. Complications of Myocardial Infarction
- Ischemic Cardiomyopathy
- Left Ventricular Rupture
- Left Ventricular Aneurysm
- Ventricular Septal Rupture
- Papillary Muscle Dysfunction (Mitral Regurgitation)
8. Infective Endocarditis
9. Intracardiac Tumors

**Cardiology:**
1. Ischemic Heart Disease (e.g., Angina, Myocardial Infarction)
2. Lower Limb Arteriosclerosis Obliterans
3. Arrhythmia
4. Heart Valve Disease
5. Aortic Stenosis
6. Mitral Regurgitation

**Lower Gastrointestinal Surgery**
*Da Vinci Si - Robot-Assisted Surgery*
1. Malignant Diseases
2. Surgical Treatment of Small and Large Intestine Diseases
3. Primarily Surgical and Medical Treatments for Colon and Rectal Cancer
4. Robot-Assisted Surgery
5. Laparoscopic Surgery
6. Multimodal Therapy Combining Surgery, Chemotherapy, and Radiation Therapy
7. Systemic Chemotherapy for Unresectable Colorectal Cancer

**Breast Surgery:**
1. Breast-Conserving Surgery
2. Mastectomy
3. Sentinel Lymph Node Biopsy
4. Lymph Node Dissection
5. Breast Reconstruction Using Autologous Tissue

**Neurosurgery:**
1. Stroke
2. Cerebral Hemorrhage
3. Subarachnoid Hemorrhage
4. Cerebral Infarction
5. Head Trauma
6. Traumatic Intracranial Hematoma
7. Skull Fracture
8. Chronic Subdural Hematoma
9. Brain and Spinal Cord Tumors
10. Acoustic Neuroma
11. Pituitary Tumor
12. Meningioma
13. Metastatic Brain Tumors
14. Functional Neurological Disorders
15. Facial Spasm
16. Trigeminal Neuralgia
17. Epilepsy
18. Normal Pressure Hydrocephalus

**Urology**
*Da Vinci Si - Robot-Assisted Surgery*
1. Robot-Assisted Laparoscopic Radical Prostatectomy
2. Prostate Cancer
3. Renal Cancer
4. Upper Urinary Tract Cancer
5. Urolithiasis (Urinary Stones)

**Radiology:**
1. Comprehensive Imaging Diagnosis (X-ray, Ultrasound, CT, MRI, Angiography, PET)
2. Liver Tumors
3. Gastrointestinal Hemorrhage
4. Arterial Embolization for Hemoptysis and Traumatic Hemorrhage
5. Transcatheter Venous Embolization for Gastric Varices
6. Intra-Arterial Chemotherapy for Cancer
7. Reservoir Placement
8. CT-Guided Biopsy (Interventional Radiology - IVR)
9. TomoTherapy - Radixact

**Dialysis**
*Travel Hemodialysis* (Available for Individual Travelers Only, Not for Groups)

**Other**
*Second Opinion* (In-person Only, Online Not Available)

Eligibility Criteria/Exclusions for Treatment

Eligibility Criteria 1. Medical Information: - Diagnosis (prostate cancer, bladder cancer, kidney cancer, urinary stones, etc.) - Cancer stage and disease status (cancer stage, tumor size, presence of metastasis, etc.) - Results from tests conducted at other institutions (MRI, CT, bone scan, biopsy results, etc.) - Presence of comorbidities (heart disease, diabetes, kidney disease, etc.) 2. Treatment History: - Previous treatment history (cancer treatment, endoscopic surgery, chemotherapy, radiation therapy) - Current medications (anticoagulants, hormone therapy, painkillers, etc.) - Known allergies or drug reactions 3. Physical Fitness and Age: - Assessment of physical capacity for elderly patients or those with underlying conditions to undergo surgery, robotic-assisted surgery, radiation therapy, or outpatient treatments - Evaluation of suitability for general anesthesia 4. Preoperative Tests and Preparation: - Ability to undergo necessary preoperative tests (blood tests, ECG, tumor marker tests, etc.) - Capability to manage lifestyle and physical health before treatment 5. Postoperative Follow-Up and Lifestyle Guidance: - Willingness to cooperate with postoperative outpatient visits and follow-up care - Compliance with lifestyle guidance and management of side effects during radiation or drug therapy

Precautions / Contraindications

Precautions and Contraindications

1. Cases Unsuitable for Treatment:
- Patients with severe heart disease or renal dysfunction who cannot tolerate surgery or anesthesia may face limitations in treatment.
- Patients unable to discontinue anticoagulants face high bleeding risks, making them unsuitable for surgery.
- Patients with conditions such as dermatitis or radiation sensitivity that make radiation therapy unsuitable may need tailored treatment approaches.

2. Risks Associated with Robotic-Assisted Surgery and Radiation Therapy:
- Surgery carries risks of bleeding, infection, urinary incontinence, and erectile dysfunction, necessitating careful postoperative monitoring.
- Radiation therapy may result in side effects such as painful urination or diarrhea, requiring close attention to health management.

3. Risk of Side Effects:
- Post-surgery or radiation therapy, immune function may be weakened, increasing the need for infection prevention.
- Recovery of urinary incontinence or erectile function following prostate surgery may be delayed, requiring regular follow-ups.

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Pre-Treatment Instructions

1. Preoperative Preparation:
- Patients taking antiplatelet or anticoagulant medications must follow medical advice regarding discontinuation.
- Necessary preoperative tests (blood tests, ECG, tumor markers, etc.) must be completed to confirm fitness for surgery.

2. Postoperative Care and Follow-Up:
- After surgery, patients must monitor for bleeding, infection, or urinary leakage and promptly contact a healthcare provider if abnormalities occur.
- Post-radiation therapy side effects, such as urinary issues or skin irritation, should be addressed with appropriate measures in consultation with a physician.

3. Lifestyle and Daily Care:
- Patients should maintain strict hygiene and infection prevention as immune function may temporarily decline.
- Gradual rehabilitation and light exercise are encouraged to rebuild physical strength and return to daily routines.

4. Regular Follow-Up:
- Post-treatment, regular check-ups, including blood tests and imaging, are essential to monitor for signs of recurrence.
- Any changes in health or new symptoms should be promptly reported to a physician.

5. Emergency Protocols:
- In cases of fever, severe pain, bleeding, or urinary abnormalities post-discharge, patients should immediately contact a medical facility.
- Emergency contact information for available healthcare providers or the attending physician should be confirmed in advance.