Clinical Department & Center



The Department of Gynecology treats all diseases peculiar to women over the course of their lifetime (neonatal period – childhood – puberty – reproductive period – menopause – old age), including tumors (benign, malignant), infectious diseases, hormone abnormalities and menopausal disorders. The Department of Gynecology covers all steps of medical care for each disease, from diagnosis to treatment (surgery, anticancer drugs, hormone therapy).


Medical care system

Professors, associate professors and other teaching staff members, as well as part-time members, graduate students and residents work together to perform diagnosis and treatment of gynecologic diseases.  
Treatment policies of patients are discussed in detail at gynecology case conferences on Monday and Wednesday mornings.
Regarding malignant tumor cases, joint conferences are held with the treatment teams of Radiation Medicine (Mondays) and Pathology (Thursdays).
Specialists in gynecologic tumors, radiation tumor therapy and pathological diagnosis form a team and use all their knowledge and skills to form a system to safely provide optimum therapy (multidisciplinary therapy).  
Concerning surgical procedures, we do not only consider a radical cure, but also patients’ postoperative quality of life (QOL) and perform autonomic nerve-sparing radical hysterectomy, radical hysterotrachelectomy, etc.
For lymphedema and urination disorders, which are postoperative complications of cancer, we provide fine-tuned guidance from soon after surgery.
Hokkaido University Hospital is a medical institution that not only diagnoses and treats gynecologic cancers, but also conducts clinical research, supports social enlightenment, and provides education of interns, residents and medical students.  
Recently, we have actively participated in multicenter clinical studies in Japan and elsewhere (JGOG and JCOG in Japan, and GOG in the United States) and can now provide the most advanced level of treatment available in the world.

Treatment policy

Our treatment policy is based on evidence. We evaluate the condition of each patient, and place importance not only on treatment outcomes, but also on QOL of body and mind.

Areas of medical care

  • General gynecology (infectious diseases, congenital diseases, menstrual disorders, benign tumors, endometriosis, etc.)
  • Malignant gynecologic tumors (cervical cancer, uterine body cancer, ovarian cancer, etc.)
  • Reproductive endocrinology (infertility, laparoscopic surgery, etc.)
  • Women’s health (menopausal disorders, osteoporosis, hormone replacement therapy, Chinese herb medicine therapy, etc.)
  • Urogynecology (incontinence, urination disorders, genital prolapse, etc.)
  • pdf Lymphedema (1.7MB)

Consultation hours

First-visit reception: 8:30 a.m. – noon on Mondays, Wednesdays and Thursdays
*A complete referral/appointment system is employed from June 2014. Please bring a referral letter.

Gynecology consultation days

Day of the week Details
Monday Gynecologic tumors, common diseases
Wednesday Gynecologic tumors, common diseases
Thursday Infertility/endocrine disease, endoscopic surgery
Returning patients have to make an appointment for the general outpatient clinic or specialty outpatient clinic.
Consultations are only available on appointment for both first-visit and return-visit patients. 

Areas of medical care

Clinic Days of the week Details
General General outpatient clinic Mondays,
General gynecologic diseases (menstrual disorders, benign tumors, sexually transmitted disease, etc.)
Specialist Tumor clinic Mondays,
Malignant gynecologic tumors (cervical cancer, uterine body cancer, ovarian cancer, etc.)
Specialist Preoperative clinic Mondays,
Preoperative consultations/tests
Specialist Tumor/colposcopy clinic Wednesdays Colposcopy (cervical cytology abnormality), after cervical conization, etc.
Specialist Infertility/ endocrine clinic Mondays,
Reproductive endocrinology (infertility, uterine myoma, endometriosis, endoscopic surgery, etc.)
Specialist Women’s health clinic Tuesdays,
Women’s health (menopausal disorders, osteoporosis, lifestyle-related diseases, hormone replacement therapy, Chinese herb medicine therapy, pelvic organ prolapse, etc.)
Specialist Urination disorder clinic Thursdays Urination disorder (postoperative)
Specialist Breast clinic Tuesdays Breast cancer screening
Specialist Lymphedema clinic,
Lymphedema care clinic
Specialist HPV vaccine clinic Monday to Thursday HPV vaccination

Medical care results

Gynecology clinical statistics (January – December 2012)

Gynecologic tumors

We provided hospitalized care to a total of 878 patients during the year, most of which were referred from other hospitals in Hokkaido.
Of them, 697 patients (79.7%) had malignant tumors (cervical cancer: 18, carcinoma in situ of uterine cervix, uterine body cancer: 31, ovarian cancer: 22). Surgical treatment, chemotherapy and radiation therapy were performed, and excellent treatment results were obtained.
A total of 240 surgical procedures were performed during the year. Aside from surgery for malignant tumors (cervix, uterine body, adnexa), the number of conization procedures for cervical intraepithelial neoplasia was 56, and the number of surgical procedures for benign uterine/adnexa tumors was 71.
We have introduced clinical pathways in the ward, and encourage patients to voluntarily participate in the treatment.
At the Department of Gynecology, gynecologists, nursing staff and ward pharmacists form a team to provide patient-oriented medical care.
We hold joint conferences with other treatment-related departments (Radiation Medicine treatment group, Pathology, Diagnostic and Interventional Radiology) on a regular basis, decide on optimum treatment policies for individual cases and build a system to safely perform such treatment (multidisciplinary therapy).
After surgery, patients’ course is followed at the tumor clinic, and meticulous care is provided to minimize the impact on patients’ QOL at the woman’s health clinic (menopausal disorders, osteoporosis), the urination disorder clinic and the lymphedema clinic.
At the breast clinic, breast cancer screening is performed for patients on hormone treatment and patients with malignant gynecologic tumors.
In clinical research, we work on the development of personalized treatment approaches for gynecologic cancers and surgical procedures for better postoperative QOL.
We also study measures to prevent osteoporosis in patients with gynecologic cancers and lymphedema, a postoperative complication.
As basic research, we pursue methods of overcoming anticancer drug resistance in case of ovarian cancer, analyze the relationship between various micro RNAs and the invasiveness of uterine body cancer, study mutations of p53 in uterine body cancer, and search lymph node metastasis markers in uterine body cancer.

Reproductive endocrinology

The number of outpatients was 8,244, and many of them were referred from other hospitals in Hokkaido.
The Reproductive Medicine Center, a fertility facility that offers assisted reproductive technology (ART) including in-vitro fertilization and micro-fertilization, was established at Hokkaido University Hospital in January 2009.
The former fertility treatment section of the Department of Obstetrics and Gynecology was reorganized as a center. In addition to doctors and embryologists, dedicated nurses are also assigned to the center, and the floor space has been expanded three times.
The improved environment allows us to provide enhanced medical care.
With the increase in the number of refractory cases, the number of eggs retrieved was 204/cycle, the number of embryos transferred was 137/cycle (fresh embryos: 21, frozen embryos: 116), the average age was 38.3 years old, and the pregnancy rate was 33.3% with fresh embryos and 35.3% with frozen embryos, while the delivery rate was 28.5% with fresh embryos and 26.7% with frozen embryos.     
In addition to the advanced treatments of in vitro fertilization and micro-fertilization, we also performed surgery in 95 cases (laparoscopic, uteroscopic, salpingoscopic surgery, and some of these were performed simultaneously) during this year to facilitate pregnancy through the treatment of underlying diseases (endometriosis, uterine myoma, etc.) and salpingoplasty.


Gynecology starts robot-assisted surgery – expectations for improved education and medical care


The Department of Gynecology performed robot-assisted surgery for malignant uterine tumor, the first of its kind at a university in Hokkaido, on July 1 (Tue.).
Compared with traditional abdominal surgery, the amount of blood loss was one tenth or less. The patient recovered smoothly and was discharged from the hospital four days later on July 5.
With traditional surgery, it takes three or four weeks before the patient is discharged. The robot-assisted surgery tremendously shortened the length of stay in hospital and allowed patients to return to society sooner.
At present, surgery is not covered by health insurance. For the time being, we will implement this surgery as a clinical study in the university hospital in the hope that it will be certified by the national government as advanced medical care and health insurance treatment.  

Background behind robot-assisted surgery

Robot-assisted surgery (also known as da Vinci surgery) provides surgeons clear vision of nerves and blood vessels, possibly manifesting its potential for nerve-sparing surgery.    
Traditional surgical procedures for cervical cancer and uterine body cancer are performed by opening the abdomen, requiring a large incisional wound.   
There are many blood vessels around the uterus, leading to the loss of a relatively large amount of blood.
Robot-assisted surgery, however, allows surgeons to see a magnified three-dimensional view of the fine blood vessels, and bleeding form each vessel can easily be stopped, significantly reducing blood loss.  
This technique is highly useful for autonomic nerve-sparing radical hysterectomy, a nerve-sparing procedure to prevent postoperative urination disorders, which have been advanced by the Department of Obstetrics and Gynecology at Hokkaido University.   

Details, target and significance of robot-assisted surgery

In terms of education, since this robot has two console boxes, and surgeons can operate from both console boxes, the operating surgeon controls the operation while a resident can learn the necessary anatomy for surgery from the same field of view.
When a young surgeon controls the operation, a medical instructor can appropriately guide and intervene. This means that robot-assisted surgery significantly helps to train doctors and improve their medical skills.  
In terms of medical care, the introduction of robot-assisted surgery provides minimally invasive surgical treatment with less impact on QOL for patients with cervical or uterine body cancer.
The Department of Genecology at Hokkaido University Hospital has consistently placed great importance on patients’ postoperative QOL and has worked on functional preservation surgery. As a result, ovary-sparing and nerve-sparing surgery for cervical cancer is now widely performed nationwide.
We have also performed uterus-sparing surgery for cervical cancer, which allows the patient to become pregnant and have a baby.  
Robot-assisted surgery is a revolutionary technique that ensures such sensitive surgical procedures.
In the future, we first wish to be certified as an advanced medical care department.  
If this surgery is often performed nationwide as advanced medical care, and its safety and effectiveness are confirmed, it will become health insurance treatment and many patients will receive benefits of this minimally invasive surgery.

Commencing time

July 2014
Overview of robot-assisted surgery  Robot-assisted surgery
Overview of robot-assisted surgery (July 1, 2014)
The robotic arms and the assistant are seen on the left side and the operator on the right side.

The operator of robot-assisted surgery and the device, called a console, where the operator controls the operation  The operator of robot-assisted surgery and the devices, called a console, where the operator controls the operation
The operator of robot-assisted surgery and the device called a console, where the operator controls the operation (July 1, 2014)

Da Vinci Si, an endoscopic surgery-assisting robot, has been introduced to our hospital. Two-dimensional images are available with traditional laparoscopic surgery. However, da Vinci Si allows surgeons to see a three-dimensional view that is magnified up to 10 times, and they can manipulate the robotic arms from console boxes. This makes it easy to save nerves and check and treat blood vessels. Unlike the traditional endoscopic forceps, da Vinci Si has joints that can turn 540 degrees, allowing for much finer movements, for example, for ablation and suturing. Da Vinci surgery requires smaller incisions than abdominal surgery, and offers a variety of benefits including less blood loss, fewer complication risks and faster recovery. The hospitalization period is much shorter than with abdominal surgery, allowing the patient to return to society sooner.
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