JAPANESE
CONTACT or
RESERVATION

About COKU

COKU is derived from the Japanese word “虚空,” which means almost zero and gentleness.

Our aim

To provide endoscopic diagnosis and treatment for digestive diseases and minimally invasive laparoscopic surgery for inguinal hernias (groin hernias) with the least possible burden on patients
DEPARTMENT of ENDOSCOPY
DEPARTMENT of SURGERY
Our Doctors
ACCESS

DEPARTMENT of
ENDOSCOPY

We mainly diagnosis and treat
gastrointestinal disease by endoscopy.

Our Strengths:

Strength❶
We provide endoscopic diagnosis and treatment in a safe　environment. Our institute has the latest endoscopic equipment with an AI system (FUJIFILM ELUXEO 8000), and we also have an inpatient facility.
Strength❷
To reduce unpleasantness as much as possible, patients can choose to be sedated during an endoscopy. And for gastroscopy, trans-nasal endoscopy is available.
Strength❸
Our endoscopic examinations are performed by endoscopists who have extensive clinical experience and are board certified fellows of the Japan Gastroenterological Endoscopy Society.
Strength❹
Gastroscopy and colonoscopy can be performed the same day.
Strength❺
We use the latest equipment to perform advanced endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for early-stage gastrointestinal cancers and polys.

Diagnoses for Diseases:

Diagnoses for Gastrointestinal Diseases by Endoscopy

If you have any of the following symptoms,
we recommend you undergo an endoscopic examination:

Heartburn and/or stomach pain

Alternating diarrhea and constipation

Abdominal pain

Bloody or/and black stools

A history of alcohol consumption
and/or smoking

A positive fecal occult blood test

Flow:

An Example of the Schedule for Gastroscopy
at COKU International

胃カメラ
You will be required to fast on the day of your examination. You must avoid milk or fruit juice, but you can drink small amounts of water.

If you are currently taking any oral medication for diabetes mellitus or cardiac disease, etc., consult your doctor in advance about taking your medication on the day of your examination.
  1. If you want to be sedated during the endoscopy, you will be given an infusion.
  2. You will be given a drug to reduce gastric bubbles.
  3. Your throat will be anesthetized. If you want trans-nasal endoscopy, the inside of your nose will be anesthetized.
  4. The doctor will insert an endoscope and use it to thoroughly observe the area from your throat to your duodenum. It depends on the individual, but the examination usually takes about seven to eight minutes.

After the Examination
The results of the examination will be explained.
Patients who have been sedated will rest for about 30 minutes.

An Example of the Schedule for Colonoscopy
at COKU International

Before the Examination
It is necessary to empty and cleanse your colon prior to the examination. Therefore, you will be asked to take a laxative either at home or our hospital on the day of your examination.

You will be required to only have a light meal or special pre-examination meal on the evening of the day before your examination. You must skip breakfast on the day of your examination. If you are scheduled to undergo the examination in the afternoon, you will also need to skip lunch.

If your bowels are not clear enough or fecal matter remains, an additional laxative or enema may be required.

The doctor will insert an endoscope to observe your rectum and colon. It depends on the individual, but the examination takes about ten to twenty minutes.
After the Examination
Please note: If you are scheduled to take a sedative during the examination, do not drive to the hospital and have someone accompany you.

Cost:

The Cost of Endoscopic Examinations

People who do not have Japanese national health insurance:
（https://www.mhlw.go.jp/stf/english/index.html）
Gastroscopy (observation only) 20,000 JPN yen
Gastroscopy with pathological examination 30,000 JPN yen
Colonoscopy (observation only) 25,000 JPN yen
Colonoscopy with biopsy 35,000 JPN yen
Gastric polypectomy 70,000 JPN yen
Colorectal polypectomy (day surgery if less than 2 cm） 70,000 JPN yen
Colorectal polypectomy (admission if more than 2 cm） 160,000 JPN yen
People who have Japanese national health insurance
（https://www.mhlw.go.jp/stf/english/index.html）
A patient who only pays 25% of the total cost for an endoscopic examination will have to pay the following:
Gastroscopy (observation only) approximately 6,000 JPN yen
Gastroscopy with pathological examination approximately 9,000 JPN yen
Colonoscopy (observation only) approximately 7,500 JPN yen
Colonoscopy with biopsy approximately 10,000 JPN yen
Gastric polypectomy approximately 21,000 JPN yen
Colorectal polypectomy (day surgery if less than 2 cm） approximately 21,000 JPN yen
Colorectal polypectomy (admission if more than 2 cm） approximately 48,000 JPN yen

For more information, please contact us.

There is a button in the lower left corner of the reservation site that enables you to select English.

CONTACT or RESERVATION

DEPARTMENT of
SURGERY

We primarily treat patients with
inguinal hernias (groin hernias).

Inguinal Hernias:

A hernia is a condition in which the intraperitoneal contents, the intestinal tract and fat, protrude through a defect or weakened part of the abdominal wall.
Inguinal hernias, also called groin hernias, are the most common type of hernia.
Inguinal hernias occur in the groin in a passageway called the inguinal canal, which runs down either side of pelvis into the sex organs.
Since inguinal hernias do not heal spontaneously, most patients with an inguinal hernia will need surgery to repair the hernia.

Diagnoses for Diseases:

Signs of an Inguinal Hernia:

If you have any of the following symptoms,
we recommend you undergo an endoscopic examination:

A visible bulge or lump (smooth mass)
in your groin area on either side of your pubic bone

Pain or discomfort in your
groin or scrotum

Dragging, pressure, or weakness
in your groin

The bulge or lump sometimes
disappears when you lie down.

If you have any of the above symptoms,
please feel free to contact us.

Treatment :

Open Surgery
Open surgery for inguinal hernias is performed through a 4–6 cm incision in the groin area using polypropylene mesh. There are various techniques, such as the Lichtenstein method, the Mesh plug method, the Kugel method, and the Direct Kugel method, depending on the type of mesh used and the site where the mesh is placed.
Laparoscopic Surgery
The surgeon makes a small incision(s) in the abdomen and uses special instruments, including a laparoscope, to repair the hernia. Laparoscopic surgery has some advantages over open surgery, such as a lower incidence of wound infections and less pain. The following are the two types of laparoscopic surgery:
TAPP
TAPP (transabdominal preperitoneal) hernia repair is performed through the peritoneum lining of the abdominal cavity.
TEP
TEP (totally extraperitoneal) hernia repair fixes inguinal hernias laparoscopically from the outside of the peritoneum.
While there are several different types of hernia surgery, we primarily perform Single-Incision TEP surgery (SILS-TEP), which is a minimally invasive treatment, to reduce the burden on inguinal hernia patients. (Depending on the patient's condition, we choose the appropriate surgical procedure.)

Flow :

Day surgery, also known as same-day surgery, means that the patient undergoes surgery and is safely discharged on the same day. Since the hospitalization time is as short as possible and the patient can return to a normal routine at an early stage, day surgery is useful for working people and parents who are taking care of small children.
Laparoscopic surgery for inguinal hernia is thought to be especially ideal for day surgery.

At COKU INTERNATIONAL, the treatment of adult patients with inguinal hernias with laparoscopic surgery is performed as day surgery. Please contact us if you would like to schedule day surgery for inguinal hernia.

(Depending on your postoperative condition, it is possible to change from day surgery to an overnight stay in the hospital.)

Cost:

The Cost of Surgery for Inguinal Hernias

People who do not have Japanese national health insurance
（https://www.mhlw.go.jp/stf/english/index.html）

The cost for laparoscopic hernia repair is 500,000 JPN yen, including pre- and post-operative examinations.

People who have Japanese national health insurance
（https://www.mhlw.go.jp/stf/english/index.html）

Although the cost may vary slightly from patient to patient depending on the amount and type of drugs used, a patient who pays 30% of the total cost for laparoscopic hernia surgery will pay approximately 100,000 to 150,000 JPN yen in total.

For more information, please contact us.

There is a button in the lower left corner of the reservation site that enables you to select English.

CONTACT or RESERVATION

Our Doctors

嶋吉 章紀

Masahisa OHTSUKA

MD, PhD, FACS

Executive Director of Medical Corporation KEIAIKAI
Director General of Nishinomiya KEIAIKAI Hospital
Minimally Invasive Therapy Department

Professional Qualifications
  • Endoscopic surgical skill qualification system: qualified surgeon (JAPAN SOCIETY FOR ENDOSCOPIC SURGERY)
  • Certified proctor for robotic assisted surgery (JAPAN SOCIETY FOR ENDOSCOPIC SURGERY)
  • Certificate of da Vinci console surgeon
  • Board Certified Fellow and Trainer of the Japan Surgical Society
  • Board Certified Fellow and Trainer of the Japanese Society of Gastroenterological Surgery
  • Board Certified Fellow and Trainer of the Japan Gastroenterological Endoscopy Society
  • Board Certified Gastroenterologist and Trainer of the Japanese Society of Gastroenterology
  • Board Certified Coloproctologist and Trainer of the Japan Society of Coloproctology
  • Members of the Delegates of the Japanese Gastroenterological Association
  • Certified doctor of the Japanese Board of Cancer Therapy
  • Councilor of the Japan Society for Endoscopic Surgery
  • Councilor of the Japan Society of Coloproctology
  • Councilor of the Kinki Surgical Association
  • Fellow of the American College of Surgeons (FACS)
  • Active member of the American Association for Cancer Research (AACR)
  • Active member of the American Society of Colon and Rectal Surgeons (ASCRS)
  • International member of the European Association for Endoscopic Surgery (EAES)
嶋吉 章紀

Manabu MIKAMORI

MD, PhD, FACS

Director surgeon of Nishinomiya KEIAIKAI Hospital
Minimally Invasive Therapy Department

Professional Qualifications
  • Board Certified Fellow and Trainer of the Japan Surgical Society
  • Board Certified Fellow and Trainer of the Japanese Society of Gastroenterological Surgery
  • Board Certified Expert Surgeon (Hepatobiliary-Pancreatic field) of the Japan Society of Hepato-Biliary-Pancreatic Surgery
  • Board Certified Trainer of the Japan Pancreas Society
  • Councilor of the Japanese Hernia Society
  • Councilor of the Japan Society for Endoscopic Surgery
  • Councilor of the Japan Surgical Association
  • Certified doctor of the Japanese Board of Cancer Therapy
  • Certified doctor of the Japanese Society for Abdominal Emergency Medicine
  • Councilor of the Kinki Surgical Association
  • Fellow of the American College of Surgeons (FACS)
嶋吉 章紀

Akinori SHIMAYOSHI

MD

Director physician of Nishinomiya KEIAIKAI Hospital
Minimally Invasive Therapy Department

Professional Qualifications
  • Board Certified Fellow of the Japan Gastroenterological Endoscopy Society
  • Board Certified Gastroenterologist and Trainer of the Japanese Society of Gastroenterology
  • Board Certified Hepatologist of the Japan Society of Hepatology
  • Fellow of the Japanese Society of Internal Medicine
  • Board Certified Occupational Doctor of the Japan Medical Association

ACCESS

Address： 7-5 Fukazu-cho, Nishinomiya, Hyogo, JAPAN 663-8203 >Google Maps
Access： Seven minutes’ walk from Hankyu Nishinomiya-Kitaguchi station
Hankyu railway route map: (https://www.hankyu.co.jp/global/en/traffic/route_map/index.html)
Phone number： +81-798-64-0059