Digestive Disease Center, Showa University Koto Toyosu Hospital

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Digestive Diseases Center, Showa University Koto Toyosu Hospital,
Tokyo, Japan

1. Examinations made by experts with a safe and effective sedation
Our excellent physicians perform the endoscopic examination in order to detect any early-stage digestive disease. Every endoscopist is trained in the use of non-anesthesiologist administration of propofol for endoscopy: This technique, even if not widely diffused in Japan jet, guarantees a safe and painless endoscopy.

2. Weekends and holidays
Most of the clinical and endoscopic activities are carried on also during weekends and holidays as same as weekdays. This commitment allow us to shorten our waiting lists and to help patients that are busy during weekdays.

3. The best equipment available
Our university hospital was completed in March 2014. We have the latest released endoscopic equipment by Olympus, the top brand in the world.

4. Spacious waiting room, pleasant recovery bed
We believe that harmony and comfort is essential for our patient. With this concept in our mind, we have taken care of any detail.

For patient from abroad interested in POEM procedure
POEM (Per-oral Endoscopic Myotomy) is a newly developed endoscopic procedure intending eternal cure from the disease. In POEM procedure esophageal myotomy is done similar to conventional surgery, but without any incision.

Overview of the Treatment Schedule For patient from abroad (Model Case: POEM)

Example Date/event	Type of admittance	Procedure (notes)
Monday/Arrival to Japan.	Outpatient	Upper endoscopy, Barium swallow, High-resolution manometry (1 day).
Thursday/Admittance to hospital	inpatient	preoperative routine exams. Nil per os from 14 o clock.
Friday/POEM procedure		Achalasia endoscopic treatment under general anesthesia
Saturday/1^st day after POEM		Barium swallow and follow up endoscopy. Patient can drink clean water.
Sunday/2^nd day after POEM		Patient can start a soft diet.
Monday/3^rd day after POEM		Patient takes a regular diet.
Tuesday/4^th day after POEM		If exams and clinical data are normal patient can be discharged.
6 months after procedure	outpatient	Upper endoscopy, Barium swallow, pH monitor, clinical assessment
1 year after procedure		Upper endoscopy, Barium swallow, pH monitor, clinical assessment
Every 3 years		Upper endoscopy (can be performed in the country of residence)

For further information, please refer to: http://www.achalasia-poem.net/for_patient.html