European - Japanese Exchange Fellowship in Rheumasurgery 2012
2012 dr. Stephan F. Schindele, hand surgeon from the Schulthess Klinik
in Zürich Switzerland, and dr. Peer van der Zwaal, shoulder and trauma
surgeon from the Medical Center Haaglanden in The Hague Netherlands,
were selected for the European Rheumatoid Arthritis Surgical Society
(ERASS) and Japan Rheumatism Foundation (JRF) Exchange Fellowship to
Japan from 2-15 September.|
In the first week we visited Tokyo, a metropole. A vast and impressive city with 30 million people living in it’s greater area. Tokyo hosts about 10 university hospitals and up to 80 community hospitals. In the second week, we travelled by air to Kyushu, the third largest island of Japan. It is a mountainous island with lots of volcanic activity, including Japan’s most acitive volcano, Mt. Aso. We visited the cities of Oita, known for it’s onsen (Japanese for hot spring), and Fukuoka, the largest city of Kyushu and traditionally a major trade city.
Our stay in Tokyo was perfectly organised by professor Shigeki Momohara, orthopaedic surgeon and director of the Institute of Rheumatology of the Tokyo Women’s Medical University. He arranged for us to visit multiple hospitals, speak with nummerous collegues and observe many surgical procedures: 1. Keio University Hospital, MCP-plasty and IP-desis by dr. Takuji Iwamoto; 2. Tokyo Women’s University Hospital, boutoniere deformity of 5th finger by dr. Kensuke Ochi; 3. Tokyo Metropolitan Bokutho Hospital, Kudo TEA by dr. Toshiyasu Nakamura, dr. Yuichi Nagase and dr. Masakazu Nakashima; 4. Tokyo University Hospital, custom made ceramic total talus replacement by dr. Yasui Tetsuro and professor Yoshinori Takakura. And much more.
The JRF organised a symposium at the beautiful Mejii Memorial Hall where we were asked to present some of our research. The symposium was chaired by professor Sakae Tanaka of the Tokyo University Hospital and lead to fruitful discussions on scientific and clinical subjects. Furthermore, the JRF organised a meeting with professor Fumimaro Takaku, president of the Japanese Association of Medical Sciences, and we had the chance to speak to him about the relationship of Japanese and European doctors.
During the week there was some time reserved for sight seeing: whilst still in our jetlag, we payed a visit to the famous Tsukiji Fish Market at 6.00am; we visited the Tokyo Sky Tree, the world’s highest tower (634mtr), the Imperial Palace, Asakusa Temple, and so on.
In Oita, we received a warm welcome by professor Hiroshi Tsumura of the Oita University Hospital. We enjoyed the volcanic activity of Kyushu by visiting the Mt. Aso and hot springs in Beppu. We were honored to be invited to diner at the home of professor Tsumura and his wife.
At the Oita University Hospital we had an extensive tour by dr. Ichiro Itonaga and dr. Masashi Miyazaki including morning report, wards and out-patient clinics. We witnessed interesting surgeries and we were even allowed to scrub in with a navigated THA by dr. Kaku and a particular anatomically designed TKA, which is unavailable in Europe, by dr. Tsumura. In the evening we gave presentations on the results of our current studies. Our stay in Oita was concluded with a fantastic farewell party with professor Tsumura and his staff.
Our travel continued by train to Fukuoka. Upon arrival we were collected from the Hakata Station by dr. Hisaaki Miyahara. He took us to the Kyushu University Hospital where we had an honorable meeting with professor Yukihide Iwamoto, chairman of the Department of Orthopaedics and current president of the Japanese Orthopaedic Association. After a tour of the state-of-the-art hospital by dr. Jun-ichi Fukushi we visited the Department of Orthopaedic Surgery of the Kyushu Medical Center, and observed THA by director dr. Miyahara. Afterwards we were able to experience a spectacular view over the city from the 234-meter high Fukuoka Tower. In the evening we were invited to perform a lecture at a specially organised meeting, followed by a delightful welcome party. Our last day was spent at the beautiful Dazaifu shrine and in the evening at Fukuoka Dome watching a baseball game of the Softbank Hawks from a private lounge.
During our endeavor in the Land of the Rising Sun we notised some striking differences between European and Japanese rheumatoid surgeons. First of all, it was intersting to note that in the Japanese Departments of Rheumatology the staff is comprised of mainly orthopaedic surgeons and only occasionally an internal medicine specialist. So orthopaedic rheumatologists perform both the medical treatment, including biologicals and DMARDs, and surgical treatment of rheumatoid patients. This way they can achieve a very complete approach to the rheumatoid patient for optimising treatment effects. Furthermore, practically all surgeons had written a Ph.D.-thesis in basic science, e.g. immunology, genetics, molecular biology, biomechanics. Often they are still involved in basic and clinical research projects at their current hospitals, resulting in high quality and high volume scientific output. Lastly, there is a major cultural difference. In the Japanese culture discipline, honor and hierachy are very important. These aspects can be appreciated throughout the whole society. They are present in every day life in the streets, at work, in the hospital, in the way doctors treat their patients, collegues, staff and vice versa. It reflects a deeply rooted respect to others as well as to oneself. We, as guests, experienced this daily as we were treated with the highest respect and honor. The organisation was absolutely flawless. The accomodations were very luxourious, all transportations were taken care off and every evening we were taken out to enjoy the exquisite Japanese cuisine.
It is our wish to continue and celebrate the friendship between Japanese and European orthopaedic societies as we feel it is very valuable in the exchange of knowledge and experience. We would like to express our gratitude and thank the ERASS and the JRF for facilitating this wonderfull exchange program, providing the fellows with the opportunity to visit Japan and to gain knowledge on cultural and orthopaedic topics.