Department of Anesthesiology

Manabu Hashimoto, Aiko Ohshita, Kenya Kunimasa, Sayako Itakura, Tsuyoshi Tokitou

Introduction

In 2017, the Center for Developing Next-generation Endoscopic-surgical Treatment (NEXT) was completed to expand surgical and endoscopic activities. The operating theater, which has twelve operating rooms, is located on the fourth floor of the NEXT building. Each room is designed for laparoscopic, thoracoscopic and other minimal invasive surgeries. The intensive care unit (ICU) on the third floor has eight beds. Postoperative patients can be transferred from the operating theater by the elevator directly to the ICU. Recently, complex procedures are increasingly being performed on more seriously ill patients with coronary disease, chronic obstructive pulmonary disease (COPD), neurological disorders and so on. The ICU plays an important role in post-anesthesia care for such patients. Therefore, we manage the operating theater in close cooperation with the Department of Intensive Care Medicine. The goals of the Department of Anesthesiology are to provide anesthetic care to patients with their safety being the highest priority.

The Team and What We Do

The Department of Anesthesiology consists of five staff members (JSA Board Certified Anesthesiologists). We perform clinical work with three or four rotating residents and 15 part-time anesthesiologists. In addition, anesthesia residents who belong to the anesthesia training program of Teikyo University started to rotate to our department in 2018. A pre-anesthesia case presentation is held every morning to examine the day’s cases and discuss the anesthesia problems and strategies for patients with various complications. In the old operating theater, which had eight operating rooms, more than 3,000 surgeries were performed each year (Table 1). With the increase in the number of operating rooms, the annual operation volume reached 4,300 in FY2021. Two features of this hospital are that there are large numbers of operations in the head and neck surgery division and procedures involving thoracotomy for lung and esophageal cancer surgeries. Accordingly, it is often necessary to apply a special anesthesia induction method for difficult airways and one-lung ventilation techniques for thoracotomy.

Table 1. Number of Surgeries

Education

Our department has no residents. We provide opportunities for rotating residents from other surgical divisions such as epidural anesthesia, one-lung ventilation techniques for thoracotomy, and difficult airway management, including fiberoptic intubation. We firmly believe that this experience is useful for the management of postoperative patients in the ward or ICU. A Journal Club is also held every other week in addition to the daily morning conference. We support residents who hope to obtain the qualification of Registered Anesthesiologist or JSA Qualified Anesthesiologist during rotation periods.