I’m also proud of the fact that I am one of the most highly-trained endoscopists in this part of the world, which means that as far as endoscopy is concerned, I have no reason to be shy of anyone in this country.
I have always loved leading-edge technology that requires precise manual dexterity. I used to work as an elite technical consultant on oil rigs in the Middle East — we were the Ferraris of the oil field, doing the kind of work that nobody else could do. But it was a lonely life on the ocean, and so I decided to move on and become a doctor instead.
Lights, Camera, Action
I found myself entranced by the field of endoscopy. Endoscopes are long, black hose-like objects with a light and a camera at the end, and an opening through which specialised tools can be inserted along the tube. These tools enable a doctor to perform resections inside a person’s body without the need to operate.
The endoscope I use now is a magnificent machine, as sleek and well-designed as a sports car. I use a 190-series Olympus endoscope with a 9.9 mm diameter insertion section worth a quarter of a million dollars, which we keep in our District 2 clinic. Its narrow-band imaging function allows me to see intestinal lesions with stunning clarity. With my Olympus 190, I am the envy of my former colleagues in Japan, and I don’t believe there are more than five such machines in this country.
I was a zealous student of the great Dr. Seiyuu Suzuki, a giant in the field, and studied with many other superb instructors. I was so engrossed by the work that I performed far more procedures than was necessary to become licensed. The one I performed most often at that time — and even still today — is the colonoscopy.
A colonoscopy involves the insertion of an endoscope into the rectum — after the bowel has been powerfully cleansed by an extreme laxative — to allow a specialist like myself to visually examine the colon for lesions that may indicate (among other things) the onset of cancer.
Many patients are reluctant to undergo a colonoscopy. However, while there are few guarantees in medicine, it is a near-certainty that people who undergo colonoscopies to screen for colon cancer will not die of this disease; they may not even need surgery. If I find a lesion today with my endoscope, I can remove it in five minutes, and there is no need to open the abdomen. That is the virtue of finding things early, and a big part of what I love about the field.
Dr. Masato Okuda is the foremost endoscopist in Vietnam
On the Hunt
Endoscopes fascinate me in that I can use them to see and confirm a suspected diagnosis. A computerized tomography (CT) scan may be able to detect that a patient is likely to have colon cancer if it’s already at an advanced stage, but in the early stages, it will probably miss it.
Through colonoscopy, I can hunt down a lesion even in the very earliest stages, and if I catch it soon enough, I can resect it immediately and the problem is gone. The tools at the tip of the endoscope allow me to inject water beneath the lesion to lift it up above the layer beneath, ensnare it, and then pinch it off for me to drag out and perform a biopsy.
The best indication of whether a patient should undergo a colonoscopy is whether he or she wants one. If a patient has any concerns about irregular bowel movements, blood in the stools, or unexplained abdominal pain, a colonoscopy is a sensible move. In fact, a regular colonoscopy (in some countries, the average period is every five years after the age of 50) is almost certain to catch colon cancer before it advances to the terminal stage. Like most cancers, colon cancer is almost completely asymptomatic until it becomes too advanced, so it is truly sad if you find it too late, and to know that if you’d had a colonoscopy two years earlier, this terminal illness could have been nothing.
The mild discomforts of the procedure are outweighed by the medical benefits, and forgive me for saying so, but I may well be the gentlest hand in these parts. Japanese patients rarely undergo colonoscopies with sedation, so it is part of our training to minimize all discomforts. In our clinic in Ho Chi Minh City, however, we always sedate our patients, which means you’ll probably be asleep for the entire thing. That’s a pity, as it means you may miss the chance to check out my breathtaking Olympus 190-series endoscope.
Dr. Masato Okuda (Internal Medicine and Gastroenterology) is a graduate of Okayama University Medical School in Japan and is noted as the foremost endoscopist in the country. He works for Family Medical Practice in Ho Chi Minh City