Centers & Services

Pediatric Surgery Department

About Pediatric Surgery

The Pediatrics Department provides medical therapy for children, for whom we diagnose and treat diseases requiring surgery in the digestive systems of children (stomach, bowels, liver, and others), respiratory systems (lungs and windpipe), genitourinary systems (kidney, bladder and others), etc.

Our physicians

Director, Pediatric Surgery Department

Takuo NodaProfessor
[Pediatric surgery, neonatal surgery, pediatric malignant solid tumor, pediatric urology]

Staff

Takanori Oyama Associate professor [Pediatric surgery, diseases of hepatobiliary system, pediatric malignant solid tumor, childhood respiratory diseases]
Morimichi Tani Associate professor [Pediatric surgery, laparoscopic surgery, pediatric urology]

*Specialty shown in [ ]

Outpatient physicians

  Monday Tuesday Wednesday Thursday Friday
Morning   Takanori Oyama Takuo Noda    
Afternoon   Takanori Oyama Takuo Noda attending  

Treatment system

Two surgeons certified as proper pediatric surgeons from the Japanese Society of Pediatric Surgeons are in charge of the department. They provide outpatient clinic service every Tuesday and Wednesday (morning and afternoon), responding to emergent patients appropriately. In cooperation with various pediatric departments, they provide medical and surgical treatments with consideration that is finely tuned for children.

Treatment policy

We provide medical and surgical care with the motto, “practice of surgical treatment not to handicap any child.” Thinking that to diminish the effect of childhood surgery to the greatest extent possible is greatly meaningful for children expected to live for a long time, we always keep it in mind. We give detailed information about surgery’s necessity and postoperative effects and obtain parents’ consent before providing surgical treatment. Additionally, we follow up our patients for a longer time, even after they reach adulthood, depending on the disease.

Specialties

We adopt less-invasive operative procedures for anorectal anomaly anal atresia and Hirschsprung’s disease to enable our patients to have good bowel function after operation. Additionally, we actively perform endoscopic operations on small children. Microsurgery techniques are introduced to surgery for newborn and premature babies to respond to fine operation.

Scope of target diseases

Body surface: inguinal hernia, umbilical hernia (protruding naval), median cervical cyst, funnel chest, etc. Neonatal diseases: diaphragmatic hernia, exomphalos/hernia of the umbilical cord, gastroschisis, esophageal atresia, intestinal atresia, etc.
Digestive system diseases: anorectal anomaly, Hirschsprung’s diseases, Meckel’s diverticulum, biliary atresia, congenital biliary dilatation, bowel intussusception, acute appendicitis, etc.
Respiratory diseases: CCAM, pulmonary sequestration, tracheal and bronchial stenosis and malacia, etc.
Genitourinary diseases: cryptorchidism, hydronephrosis and hydroureter, vesicoureteral reflux, hypospadias, etc.
Solid tumors: surgery of malignant and benign solid tumors such as neuroblastoma, hepatoblastoma, nephroblastoma (Wilms tumor), rhabdomyosarcoma, (malignant) teratoma.

Description of medical care

  • We provide short-term inpatient clinical service for patients with inguinal hernia, umbilical hernia (protruding naval), and cryptorchidism. It is necessary to perform cryptorchidism surgery when the patient is around one year old.
  • Many diseases the pediatric department targets are congenital abnormalities and benign diseases. After making a sufficient assessment of the effects of the disease on a patient, we provide surgical treatment when needed.
  • As for the treatment of congenital biliary dilatation, the department has had world-leading performance by virtue of the work of Professor Takuji Todani, known as the founder of Todani’s classification. Using an operative method by which total excision of the extrahepatic biliary tract is made from the hepatic portal region to the inner portion of pancreas and using a large incision of hilar hepatic duct ollowing end-to-end anastomosis between the hilar hepatic duct and jejunum, we make every effort to reduce the incidence of postoperative complications, such as anastomotic stenosis and biliary cancer, to the lowest probable level.
  • Aiming at less invasion, functional preservation and unnoticeable operative wound, we are willing to introduce techniques such as endoscopic surgery and microsurgery.
  • In many cases, neonatal diseases are highly acute. Therefore, they are managed in the NICU. When a disease is diagnosed before birth, the therapeutic strategy is discussed in conference with physicians from obstetric, pediatric (neonatal), and anesthesiological departments.
  • For childhood malignant solid tumors including neuroblastoma, hepatoblastoma, and nephroblastoma (Wilms tumors), we provide multidisciplinary treatments combined with chemotherapy, radiation therapy, and surgery according to protocols that are appropriate to the stage, conducted in cooperation with pediatric and radiological departments.
  • To improve the QOL of children with severe motor and intellectual disabilities, we perform gastrostomy, antireflux surgery, and laryngo-tracheal separation. In such cases, it is most important to evaluate how the surgery can improve the patient QOL and to obtain a guardian or caregiver’s consent before operation.
  • We also prepare and improve treatments for pediatric urological diseases. Treatment plans of vesicoureteric reflux (VUR) vary among conservative management, endoscopic surgery, and conventional treatment, depending on the degree of disease severity. Regarding hypospadias, where possible, we strive to perform radical procedure when a patient is two or three years old. If hypospadias develops to a high degree, we sometimes perform surgeries twice.
  • In surgeries for funnel chest, we adopt Nuss method to elevate the retracted sternum using a metal bar along the rib cage. In contrast to conventional methods, the method requires no large operative wound on the precordium, but two or three small wounds on the side chest. The surgery can be performed in a short time, entailing very little bleeding.

Frequently performed tests

For the diagnosis and assessment of treatment effects, children also require various tests, which are identical to those administered to adults.
For gastrointestinal series and urography, we try to perform the tests in a short time to reduce fear, pain, and radiation exposure to the greatest degree possible.
During CT or MRI examination, which require children to be put under sedation (using oral medication or anesthetic), a physician is sure to attend the patient.
Esophagogastroduodenoscopy and bronchoscopy are conducted under general anesthesia.