ESCP’s 2017 Japan Travelling Fellow was Fraser Smith. Over the next few weeks we’ll be sharing Fraser’s dispatches from his travels. Here's Part 1...

Sushi with Dr KonishiSelfie at entrance to the robot show

Sushi with Dr Konishi and Selfie at robot show

As someone who has a very active clinical and research interest in non-operative and minimally invasive management of rectal cancers, I have become interested in the optimal ways to diagnose and accurately stage early rectal cancers. I now appreciate the huge importance that endoscopic submucosal dissection (ESD) has in this scenario. This is a technique that has been developed and mastered in Japan but is still relatively un-common in the UK and was one of the main reasons why I was so keen to be awarded this fellowship; to see it in practice. I was also curious and interested to see and learn more about extended lymphadenectomy for colon and rectal cancer as it is so key to Japanese surgery but is hardly done in the UK at all. As such, it was largely upon these factors that I based my application for this prestigious fellowship. I was also very keen to visit Japan on a personal level as I have been deeply interested in Japanese art and culture since an early age but have never had the opportunity to visit.

When I received notification that I had been awarded the fellowship I was really overjoyed and excited. I knew that this would be a once in a lifetime experience. My introduction to the characteristic Japanese friendliness and efficiency came shortly after receiving notification of winning the award with an email from Mr Takashi Akiyoshi who was last year’s ESCP European Travelling Fellow, and a very well-known and skilled Japanese surgeon. From the word 'go' he was fantastic at helping me organise my itinerary and had planned an action-packed time from the moment that my plane arrived in Tokyo! Japanese efficiency could not conceptualise the British Weather though so I arrived 5 hours late, 9 hours ahead of GMT, after having to transfer airline and country because of fog in Manchester. I was very happy and excited to have arrived…. but really exhausted because of jet lag and the length of the journey. After a short ride on the metro and checking in at my hotel I went with Dr Akiyoshi to a cruise that he had booked around Tokyo Harbour called a Yakatabune - a traditional Japanese culinary riverboat. Like I say I was very tired and a bit spaced out at this stage and genuinely, once I entered this boat, if you had told me that I had in fact died and gone to heaven I would have believed you! It was a beautiful crisp evening as we slipped around the bay enjoying each other’s company and being served sensationally good food and crisp, cool Japanese beer taking in stunning views of the illuminated Tokyo skyline. It really was amazing.

The following day (Sunday), after a very deep and satisfied sleep, I met Mr Tsyoshi Konishi, who is a laparoscopic surgeon of distinction in Japan, and someone that I was already friendly with after meeting him at the Ficare meeting in Brazil 2 years ago. He kindly took me to the famous Tsukiji Fish Market, the biggest in the world, for sushi. It was great to catch up with him but also the sushi was out of this world. It was my first time trying sea urchins which for me was quite special as I remember when I was a small boy at the beach my parents told me that Japanese people ate sea urchins and I was amazed. Now I was there, in Japan, and eating them!! That day there was a tornado forecast and so Dr Konishi said that he would stay indoors and advised me to do the same. Although initially a bit cautious, I soon realised that this situation was quite funny because actually what was regarded as bad weather in Japan really amounted to a mediocre Scottish Summer’s day with lashing rain!! Unperturbed, therefore, I continued to explore Tokyo! I took the metro to the Meiji Shrine which is a very famous landmark. Probably because of the weather it was pretty quiet and I enjoyed looking around both the shrine and the beautiful gardens that surround it. I then ambled my way back through the streets of Tokyo towards my hotel. Before I had gone to Tokyo, I had been told that there was a really zany and fun robot show. I had asked my hosts about it but they did not seem too impressed. As I ambled my way back towards my hotel, guided by Google Maps, I realised that I was right beside it. I decided to go to it anyway and it was completely over the top and was pretty funny but I can completely understand why my hosts were not keen to go there when I had mentioned it previously! After that I returned to my hotel ready to begin the clinical aspects of my visit. 

Read Part 2 here >

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