It was my great honor to have been selected as the JSCP/ESCP travelling fellowship to Dublin in 2015. My experience to attend ESCP meeting and to visit St James’s hospital of Leeds University, Örebro University and Karolinska Institute were both exciting and inspiring.
St. James’s Hospital, Leeds University, UK
Prof. David Jayne kindly planned my itinerary during my visit and guided me around several parts of the hospital. I wanted to visit Prof. Jayne because he has conducted great randomized controlled trials such as CLASSIC trial and ROLLAR trial. Unfortunately, I was not able to experience any of his operations, however, I had the chance to see operations performed by Prof. Peter Sagar and Dr. Julian Hance. Dr. Hance kindly took care of me. I was impressed in the total colectomy for FAP performed by robotically and laparoscopically. I recognized again that robotic surgery is introduced routinely in daily clinical practice in UK. In Japan, robotic surgery for colorectal disease is not covered by the health insurance system. In the operation theatre, I reflected on what the Japanese situation might be like in 10 years time.
ESCP meeting, Dublin
After visiting Leeds University, I moved to Dublin to attend the 10th ESCP meeting. In the visiting fellow free paper session, I had a presentation entitled “Randomized controlled trial of high or low ligation of IMA in anterior resection for rectal cancer”. It was my first presentation in English in such a big auditorium. I tried to speak slowly and simply. It was my great honor to be praised by several European surgeons after the presentation. Concerning contents of the meeting, I felt the difference between ESCP and JSCP. There were many sessions concerning benign colorectal disease such as IBD or functional disorder. Most of the sessions in JSCP are consisted of malignant disease and it was really educational for me to attend such sessions. Especially, I was very impressed by the session on sacral nerve modulation which has only just been approved by the Japanese health insurance system.
The ESCP dinner was held at Trinity College. It was a wonderful and noble ceremony. After the ESCP meeting, Prof. Ronan O’Connell invited us to a reception at his home. His hospitality was really great, and it was my precious experiences to have a friendship with celebrated surgeons from all over the world. Before flying to Sweden, I visited the world heritage sites of Newgrange and Hill of Tara. It was a sacred place. It was my great pleasure to get a sense of the origins of Ireland.
Örebro University, Sweden
I had requested to visit Prof. Peter Matthiessen in Örebro University, because I was very interested in his works concerning diverting stoma, anastomotic leakage and bowel function. It was my great experience to discuss with him several issues about colorectal disease. He taught me about the Swedish colorectal registry: all colorectal cancer operations are required to be registered. There is not such a great registration system in Japan. In my opinion, Japanese surgeons should make these systems as soon as possible. I am convinced that advanced clinical reports from Sweden are based upon this registration system. Prof. Matthiessen also kindly invited me to his beautiful house. This will remain in my memory forever.
Karolinska Hospital, Sweden
I have long wanted to visit to Karolinska Institute, because it is one of the most famous medical institutes in Europe. Prof. Anna Martling taught me various things such as about the Stockholm trial, ongoing trials and future planned trials. Her teaching was extremely clear and I was very impressed by the strong mission of Karolinska Institute to find new evidence.
Prof. Torbjörn Holm entirely took care of me. I was allowed to participate in one of his operations, recurrent rectal cancer after abdominoperineal resection. Although it was very challenging operation, Prof. Holm and Dr. Palmer performed the total pelvic excision with sacrum resection quite smoothly. The specimen was completely perfect with no tumor exposure. The creation of urostomy and gluteus muscle flap reconstruction was performed by Prof. Holm himself. 
The operation time and blood loss were relatively short and small for such a big surgery. I realised that his extensive experience of extralevator abdominal excision enabled him to perform such a great operation. This wonderful surgery is burned into my memory.
After the training, he invited me to a fascinating traditional Swedish restaurant. He said to me that surgeons should keep improving their surgical skill. In Stockholm, I swore not to forget this maxim for as long as I am a surgeon.
Finally...
I would like to express my gratitude to all the parties concerned. This exchange fellowship is an excellent system to develop knowledge and experience. I sincerely hope it will be continued forever.
Kenji Matsuda, MD, PhD
Second Department of Surgery, Wakayama Medical University, Japan
