Updated on 2024/03/19

写真a

 
KAWATE, Norihiko
 
Affiliation
Faculty of Human Sciences, School of Human Sciences
Job title
Professor
Degree
Docotor of Medicine ( Tokyo Medical University )

Professional Memberships

  •  
     
     

    Japan Surgical Society

  •  
     
     

    The Japan Lung Cancer Society

  •  
     
     

    The Japan Society for Respiratory Endoscopy

  •  
     
     

    The Japanese Society of Clinical Cytology

  •  
     
     

    The Japanese Association for Chest Surgery

Research Interests

  • Cancer, Lifestyle-related diseases, General Medicine, Rehabilitation Medicine, Health Surveillance Medicine, Emergency Medicine

 

Papers

  • Maximizing Use of Robot-Arm No. 3 in Da Vinci-Assisted Thoracic Surgery

    Naohiro Kajiwara, Junichi Maeda, Koichi Yoshida, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    INTERNATIONAL SURGERY   100 ( 5 ) 930 - 933  2015.05  [Refereed]

     View Summary

    We have previously reported on the importance of appropriate robot-arm settings and replacement of instrument ports in robot-assisted thoracic surgery, because the thoracic cavity requires a large space to access all lesions in various areas of the thoracic cavity from the apex to the diaphragm and mediastinum and the chest wall.(1-3) Moreover, it can be difficult to manipulate the da Vinci Surgical System using only arms No. 1 and No. 2 depending on the tumor location. However, arm No. 3 is usually positioned on the same side as arm No. 2, and sometimes it is only used as an assisting-arm to avoid conflict with other arms (Fig. 1). In this report, we show how robot-arm No. 3 can be used with maximum effectiveness in da Vinci-assisted thoracic surgery.

    DOI

    Scopus

    3
    Citation
    (Scopus)
  • Cost-benefit performance of robotic surgery compared with video-assisted thoracoscopic surgery under the Japanese national health insurance system

    Naohiro Kajiwara, James Patrick Barron, Yasufumi Kato, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    Annals of Thoracic and Cardiovascular Surgery   21 ( 2 ) 95 - 101  2015

     View Summary

    Background: Medical economics have significant impact on the entire country. The explosion in surgical techniques has been accompanied by questions regarding actual improvements in outcome and cost-effectiveness, such as the da Vinci&lt
    sup&gt
    ®&lt
    /sup&gt
    Surgical System (dVS) compared with conventional video-assisted thoracic surgery (VATS). Objective: To establish a medical fee system for robot-assisted thoracic surgery (RATS), which is a system not yet firmly established in Japan. Methods: This study examines the cost benefit performance (CBP) based on medical fees compared with VATS and RATS under the Japanese National Health Insurance System (JNHIS) introduced in 2012. Results: The projected (but as yet undecided) price in the JNHIS would be insufficient if institutions have less than even 200 dVS cases per year. Only institutions which perform more than 300 dVS operations per year would obtain a positive CBP with the projected JNHIS reimbursement. Conclusion: Thus, under the present conditions, it is necessary to perform at least 300 dVS operations per year in each institution with a dVS system to avoid financial deficit with current robotic surgical management. This may hopefully encourage a downward price revision of the dVS equipment by the manufacture which would result in a decrease in the cost per procedure.

    DOI PubMed

    Scopus

    9
    Citation
    (Scopus)
  • High-speed 3-dimensional imaging in robot-assisted thoracic surgical procedures

    Naohiro Kajiwara, Soichi Akata, Masaru Hagiwara, Koichi Yoshida, Yasufumi Kato, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    Annals of Thoracic Surgery   97 ( 6 ) 2182 - 2184  2014

     View Summary

    We used a high-speed 3-dimensional (3D) image analysis system (SYNAPSE VINCENT, Fujifilm Corp, Tokyo, Japan) to determine the best positioning of robotic arms and instruments preoperatively. The da Vinci S (Intuitive Surgical Inc, Sunnyvale, CA) was easily set up accurately and rapidly for this operation. Preoperative simulation and intraoperative navigation using the SYNAPSE VINCENT for robot-assisted thoracic operations enabled efficient planning of the operation settings. The SYNAPSE VINCENT can detect the tumor location and depict surrounding tissues quickly, accurately, and safely. This system is also excellent for navigational and educational use. © 2014 by The Society of Thoracic Surgeons Published by Elsevier Inc.

    DOI PubMed

    Scopus

    10
    Citation
    (Scopus)
  • Extended indications for robotic surgery for posterior mediastinal tumors

    Naohiro Kajiwara, Masatoshi Kakihana, Jitsuo Usuda, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    Asian Cardiovascular and Thoracic Annals   20 ( 3 ) 308 - 313  2012.06

     View Summary

    Previously, we evaluated use of the da Vinci Surgical System for anterior and middle mediastinal tumors in clinical cases, focusing on feasibility, safety, and appropriate settings. In this study, we evaluated extending the indications for robotic surgical treatment of posterior mediastinal tumors to include those located adjacent to the upper vertebrae or aorta. Three patients with mediastinal tumors located immediately adjacent to the vertebrae or aorta, underwent resection with the da Vinci Surgical System. All resected tumors were benign histologically. Robotic surgery enabled treatment of tumors located in the posterior mediastinum, which are very difficult to reach, making resection with the conventional video-assisted thoracoscopic surgery technique extremely difficult. All procedures were performed safely, smoothly, and extremely precisely. Crucial to the success of these operations were the appropriate placement and angle of the special da Vinci surgical ports in relation to the target and the patient's position, which varied according to the tumor location. © The Author(s) 2012.

    DOI PubMed

    Scopus

    21
    Citation
    (Scopus)
  • Interventional management for benign airway tumors in relation to location, size, character and morphology Journal of Thoracic Disease

    Naohiro Kajiwara, Norihiko Kawate, Norihiko Ikeda

    J. of Thoracic Diseases   3 (4)   221 - 230  2011.12

  • Training in Robotic Surgery Using the da Vinci (R) Surgical System for Left Pneumonectomy and Lymph Node Dissection in an Animal Model

    Naohiro Kajiwara, Masatoshi Kakihana, Jitsuo Usuda, Osamu Uchida, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY   17 ( 5 ) 446 - 453  2011.10  [Refereed]

     View Summary

    Objectives: In Japan, as of March 2010, only 13 hospitals were using the da Vinci system and only for selected cases. Few clinical robotic lung surgery has been done in Japan, and there are no standardized training programs, although some exist in the U.S. and are under consideration by the Japanese society for thoracic surgery. We have used the da Vinci S (R) Surgical System for pneumonectomy and lymph node dissection in pigs. We report and review future possibilities and problems of robotic surgery, especially concerning education, training, safety management and ethical considerations for pneumonectomy and lymph node dissection in clinical practice.
    Methods: The da Vinci (R) system consists of a surgeon's console connected to a patient-side cart, a manipulator unit with three instrument arms and a central arm to guide the endoscope. The surgeon, sitting at the console, triggers highly sensitive motion sensors that transmit the surgeon's movements to the instrument arm.
    Results: We experienced exactly the same sensation as when performing standard open thoracotomy. Visual recognition is 3-D, and the high manipulation potential allows free movement of the various accessory instruments, exceeding the capacity of a surgeon's hands in video-assisted thoracic surgery (VATS) or even standard thoracotomy.
    Conclusions: Robotic surgery achieves at least the same level of operation technique for pneumonectomy and lymph node dissection under standard open thoracotomy, and it seemed as safe and easily performed as conventional VATS. The training program using pigs was effective and holds promise as a system to train thoracic surgeons in robotic lung surgery.

    DOI

    Scopus

    8
    Citation
    (Scopus)
  • Appropriate set-up of the da Vinci® Surgical System in relation to the location of anterior and middle mediastinal tumors

    Naohiro Kajiwara, Masatoshi Kakihana, Norihiko Kawate, Norihiko Ikeda

    Interactive CardioVascular and Thoracic Surgery   12   112 - 116  2011.10

  • Cine MRI enables better therapeutic planning than CT in cases of possible lung cancer chest wall invasion

    Naohiro Kajiwara, Soichi Akata, Osamu Uchida, Jitsuo Usuda, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    LUNG CANCER   69 ( 2 ) 203 - 208  2010.08  [Refereed]

     View Summary

    The objective: To evaluate the hypothesis that lung cancer treatment planning (whether or not to use induction therapy) can be improved if respiratory dynamic cine magnetic resonance imaging (RD MR) is used.
    Method: We studied 100 lung cancer patients, 76 men and 21 women, scheduled for thoracotomies between May 1997 and December 2006 wherein it was unclear preoperatively whether chest wall invasion would be found. We evaluated the accuracy of RD MR as compared with the findings at operation and postoperative pathology. The accuracy of RD MRI for evaluating chest wall invasion was compared with the efficacy of CT and MRI within our own group of patients and with data from the studies of other investigators.
    Results: Concerning the evaluation of chest wall invasion, conventional computed tomography (CT) had 43.9% specificity, 60.0% sensitivity and 47.1% accuracy, while RD MR had 68.5% specificity, 100.0% sensitivity and 77.0% accuracy. RD MRI was particularly useful in the evaluation of cancers around 5 cm in diameter that were located adjacent to the diaphragm. Postoperative evaluation of superior sulcus tumor cases that had received induction therapy also showed that the RD MR procedure enabled an accurate decision in 87.5% of cases, and there were no false negative cases.
    Conclusions: RD MR is more useful than CT or standard MRI for evaluating thoracic wall invasion. This noninvasive method enhances the reliability of deciding whether induction therapy should be employed. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

    DOI

    Scopus

    46
    Citation
    (Scopus)
  • スコープ「海と海図」

    河手典彦

    日本呼吸器内視鏡学会雑誌   27(6)   431 - 432  2005.06

  • 胸腔ドレーン管理(共著)

    河手典彦, 玉地義弘

    消化器外科NURSING、メディカ出版   6 ( 12 ) 35 - 41  2001.11

  • 最新の治療指診今日の腫瘍外科、肺の腫瘍性疾患-扁平上皮癌(共著)

    河手典彦, 加藤治文

    外科治療2000増刊、永井書店   82   307 - 316  2000.05

  • 放射線治療のLatest情報(共著)

    河手典彦, 坪井正博, 日吉利光, 中村治彦, 小中千守, 加藤治文

    Practical Oncology   13   9 - 12  2000.04

  • 臨床研究の進歩と最新動向-特集肺癌:分子生物学研究を基礎とした最新の診断と治療学 気管支鏡検査(共著)

    河手典彦, 土田敬明, 垣花昌俊, 坪井正博, 古川欣也, 奥仲哲弥, 小中千守, 加藤治文

    日本臨床   58 ( 5 ) 71 - 78  2000.04

  • 細胞診-21世紀への展望---呼吸器外科外来(共著)

    河手典彦, 大平達夫, 小中千守, 加藤治文

    臨床検査・増刊号、医学書院   44 ( 11 ) 1232 - 1239  2000.04

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Books and Other Publications

  • Surgical textbook for nursing

    ( Part: Joint author)

    2017.08

  • 肺癌細胞診断 形態とその臨床 改訂版 第2章 肺癌の確定診断法 8.CTガイド下針生検

    河手典彦

    ベクトル・コア  2013.11

  • ナースの外科学 改訂第6版 各論5 呼吸器疾患

    池田徳彦, 河手典彦

    中外医学社  2013.01

  • ロボット手術の現況と展望

    梶原直央( Part: Joint author)

    金原出版  2012.11

  • 呼吸療法テキスト 10気道管理-3気管支鏡

    学会合同呼吸療法認定士認定委員会( Part: Joint author)

    アトムス  2012.06

  • 呼吸器内視鏡診断 所見・病理からみたアプローチ 第2章B-Ⅲ 気管・気管支の良性腫瘍

    梶原直央, 佐藤永一, 河手典彦

    南山堂  2011.11

  • 医科栄養学 section4 周手術領域4-1 術前栄養管理、4-2 術後栄養管理

    河手典彦, 梶原直央, 池田徳彦

    建帛社  2010.09

  • 現代人間科学講座第3巻 「健康福祉」人間科学 4.健康福祉を支える臨床医科学(2)、4.2臨床医学とリハビリテーション

    河手典彦

    朝倉書店  2008.06

  • 徹底ガイド 肺癌ケア Q&A (No.19) 看護に必要な肺がんの基礎知識 臨床症状と診断5.肺がんの発見動機と症状

    河手典彦

    総合医学社  2008.01

  • 徹底ガイド 肺癌ケア Q&A (No.19) 看護に必要な肺がんの基礎知識 臨床症状と診断5.肺がんの発見動機と症状

    河手典彦

    総合医学社  2008.01

  • 肺癌診療二頁の秘訣、喘鳴と肺癌

    河手典彦

    金原出版  2004.10

▼display all

Research Projects

  • Then analysis of lung cancer protein using two-dimensional polyacrylamide gel electrophoresis Application for adjuvant chemotherapy

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research

    Project Year :

    1998
    -
    1999
     

    HIRANO Takashi, KONAKA Chimori, KAWATE Norihiko, IKEDA Norihiko, KATO Harubumi

     View Summary

    1. Sixteen polypeptides associated with histopathological differentiation were detected using two-dimensional polyacrylamide gel electrophoresis of primary lung carcinoma.
    2. Based on the expression of the polypeptides associated with either histopathological differentiation or cell proliferation, we classified primar lung adenocarcinoma into typical case and atypical case. 65.4% of the typical cases were diagnosed as well differentiated adenocarcinoma histopathologically. Also, 65.4% of the typical cases showed negative in lymph node metastasis. On the other hand, 20.5% and 34.9% of the atypical cases were judged as well differentiated case and cases without lymph node metastasis, respectively. Furthermore, we recognized the statistically significant difference in three year-disease free survival(62.9% in typical cases, 27.1% in atypical cases ; p=0.0011).
    3. We produced monoclonal antibodies against N-terminal of TA02 molecule. The histological distribution of TA02 was clarified immunohistochemically using this antibody and human tissues. Also, we obtained the evidence that TA02 molecule was homologos with NapsinA which was a novel aspartic proteinase published at the end of 1998, because the adenocarcinoma cases with high expression of TA02 showed the expression of napsin A in RNA level. Furthermore, GST fusion protein of Napsin A showed positive reaction with anti-TA02 antibody.
    4. TS02 associated with neuroendocrine cells was homologous with protein gene product 9.5(PGP 9.5). In the TS02 positive cases two-years prognosis become worse compared to TS02 negative cases.
    5. Compred to the 2DE patterns between CDDP-resistant cell line and the parents cell line, the positions of reticulocarbin and glutathione-S-transferase π were identified on 2DE gel. The expession level of reticulocalbin, which was Ca-binding protein at endoplasmic reticulum, became low in the CDDP-resistant cell line. On the other hand, the expression level of GST-πbecame high, remarkably.
    6. The analysis based on lung cancer protein using 2DE is valuable for the evaluation of biological tumor malignancy.

  • Then analysis of lung cancer protein using two-dimensional polyacrylamide gel electrophoresis Application for adjuvant chemotherapy

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research

    Project Year :

    1998
    -
    1999
     

    HIRANO Takashi, KONAKA Chimori, KAWATE Norihiko, IKEDA Norihiko, KATO Harubumi

     View Summary

    1. Sixteen polypeptides associated with histopathological differentiation were detected using two-dimensional polyacrylamide gel electrophoresis of primary lung carcinoma.
    2. Based on the expression of the polypeptides associated with either histopathological differentiation or cell proliferation, we classified primar lung adenocarcinoma into typical case and atypical case. 65.4% of the typical cases were diagnosed as well differentiated adenocarcinoma histopathologically. Also, 65.4% of the typical cases showed negative in lymph node metastasis. On the other hand, 20.5% and 34.9% of the atypical cases were judged as well differentiated case and cases without lymph node metastasis, respectively. Furthermore, we recognized the statistically significant difference in three year-disease free survival(62.9% in typical cases, 27.1% in atypical cases ; p=0.0011).
    3. We produced monoclonal antibodies against N-terminal of TA02 molecule. The histological distribution of TA02 was clarified immunohistochemically using this antibody and human tissues. Also, we obtained the evidence that TA02 molecule was homologos with NapsinA which was a novel aspartic proteinase published at the end of 1998, because the adenocarcinoma cases with high expression of TA02 showed the expression of napsin A in RNA level. Furthermore, GST fusion protein of Napsin A showed positive reaction with anti-TA02 antibody.
    4. TS02 associated with neuroendocrine cells was homologous with protein gene product 9.5(PGP 9.5). In the TS02 positive cases two-years prognosis become worse compared to TS02 negative cases.
    5. Compred to the 2DE patterns between CDDP-resistant cell line and the parents cell line, the positions of reticulocarbin and glutathione-S-transferase π were identified on 2DE gel. The expession level of reticulocalbin, which was Ca-binding protein at endoplasmic reticulum, became low in the CDDP-resistant cell line. On the other hand, the expression level of GST-πbecame high, remarkably.
    6. The analysis based on lung cancer protein using 2DE is valuable for the evaluation of biological tumor malignancy.

  • Development of Photodynamic Therapy for Malignant Tumors

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research

    Project Year :

    1985
    -
    1987
     

    HAYATA Yoshihiro, KAWATA Norihiko, KONAKA Chimori, AIZAWA Kastuo, KATO Harubumi, YONEYAMA Kazuo

     View Summary

    Photodynamic therapy (PDT) is based on incorporation of a photosensitizer that has high affinity for malignant tissue and stimulation of the photosensitizer with a low power laser beam, with tumorcidal effects. Using the same principle fluorescence can also be elicited from the tumor by a laser beam of a different wavelength in order to detect the lesion. Our team has investigated this therapeutic modality in basic and clinical studies for ten years. Our initial studies employed hematoporphyrin derivative (HpD) as the photosensitizer for PDT with an argon dye laser and we have reported the first cases of five-year survival in a case of cancer treated only by PDT.Mono-L-aspartyl chorin e (NPe ) is a photosensitizer newly developed in 1987. This material shows higher affinity to tumor and better light absorption than HpD. It has a strong absorption band at a wavelength longer than 600nm and consequently is not affected by hemoglobin. Further investigations are necessary for clinical application.An excimer dye laser which more powerful than the argon dye laser has been developed for clinical applications. This laser equipment makes it possible to diagnose and treat in the same procedure by a wavelength-change device. Especially for diagnoses, the fiberscopic image, fluorescent light, and fluorescent wave length are shown in the same image.The basic experiment of photodynamic therapy has been performed. HpD and NPe have been shown to have a high affinity for mitochondria. Damage to the mitochondria by photosensitizer was recognized by decrease in mitochondrial movement. This is in agreement with theories that the first step of photodynamic therapy is degeneration of mitochondria.In 1987 the basic investigation, the laser equipment and the newly developed photosensitizer for photodynamic therapy were established. Our proposed project is a clinical trial and comparison with PDT using HpD and argon dye laser, as well as with other modalities

 

Sub-affiliation

  • Faculty of Human Sciences   Graduate School of Human Sciences