Postcards from Japan: Through the Eyes of a Surgeon

A Dream Year in the Making

It all began with a dream—a dream that first took root during the TYSA Finals, where four intense rounds of competition made one thing clear: I wanted to push my boundaries. I had heard about the precision and perfection of Japanese surgeons for years, and somewhere deep within, I knew that if I wanted to learn from the best, Japan had to be a part of my journey. Thanks to the travel grant I received, I found myself preparing for a once-in-a-lifetime observership at the University of Tokyo's Department of Hepatobiliary, Pancreatic, and Liver Transplant Surgery.

My month-long stay would include not just my time in Tokyo, but also a scientific presentation at the JSS Congress in Sendai and a concluding observership with Professor Noriyuki Inaki at Kanazawa University. But before all that unfolded, Week 1 already had stories worth telling.

Day 0: The Landing and the Labyrinth

March 31st 2025, I landed at Narita International Airport with a backpack full of expectations and excitement. The Tokyo metro system welcomed me with a maze of platforms and signs, most of which I didn’t understand. Even before I reached my accommodation at Nishikasai, I had already learned Lesson 1: Navigation here demands precision. A 1.5 km taxi ride cost me nearly 1500 yen—that’s Rs. 800 for a short stretch! Still, it was all part of the experience.

Day 1: First Impressions and Radiology as an Art Form

April 1st 2025. I was greeted by Dr. Kurosako, a kind and ever-helpful fellow at the University Hospital. He showed me around the hospital, which I initially mistook for a mall until I saw a patient in a wheelchair with IV lines. Soon after, I was introduced to Professor Hasegawa, the department chief, the world renowned Hepatic surgeon and the descendent of Prof. Mafucci. Despite language barriers, they were gracious enough to summarize important discussions in English. What truly stunned me was how effortlessly the surgeons read radiology—with the kind of ease most of us read text messages.

It was raining that evening. I took the time to buy warm clothes, a pair of waterproof shoes, and thermal inners. Day 1 was both intimidating and inviting—a glimpse into the kind of rigor that lay ahead.

Day 2: Precision in Action

April 2nd 2025. Today I observed a robotic segment IV hepatectomy performed by Professor Kawaguchi, "the best in the world for Minimal Invasive Liver resections" as per Dr. Kuro San. The entire operation was a visual symphony: from the Da Vinci robot arms to ICG-guided ultrasonography and bloodless resection. I was particularly amazed by the absence of any tachycardia or blood transfusion requirement during such a major surgery.

The day concluded with something unexpected and heartwarming: my unit under Prof. Kawaguchi hosted a welcome dinner for me. Their warmth and inclusion made the technical brilliance feel even more special.

Day 3: Solitude Breaks, Sutures and Sushi

April 3rd 2025. I met Dr. Mohib, my fellow Indian Resident and co-observer here, which marked the end of my solo stint in the city. After a small conference at the university, I had some free time and ventured out to Asakusa. The vibrant market streets, the traditional food stalls, and the smell of sweet rice cakes created a beautiful sensory collage.

Later that night, I visited an Onsen for the first time. The therapeutic bath was like a cultural reset. The contrast between a hectic hospital morning and a tranquil Japanese evening was surreal.

Day 4: The Art of Healing

April 4th 2025. I watched Dr. Hasegawa perform an open extended liver hepatectomy via the modified Mafucci incision with minimal blood loss and flawless execution. Dr. Kuro San also performed a laparoscopic cholecystectomy, and I noticed how smoothly their surgical team worked—each step as rehearsed as a theatre production. But what really stood out today was the seamless use of innovation. From the use of 2mm and 3mm ports to ICG guidance and intraoperative ultrasound, everything felt ahead of its time.

The evening was reserved for Chidorigafuchi’s moat walk, where the cherry blossoms were in full bloom. A light drizzle made it all the more magical. A full course Indian meal at Mumbai restaurant ended the day.

Day 5: Laparoscopy Meets Robotics

April 5th 2025. I spent the morning at Yotsuya Medical Cube under Professor Imamura. I observed a TAPP and laparoscopic cholecystectomy where 2mm instruments were used. What caught my eye was a custom-built robotic arm that offered 360° maneuverability—even more flexible than the Da Vinci. The entire surgery was done solo by the surgeon with just a robotic assistant. Professor Imamura also showed me the suturing kits he has innovated for practicing in difficult angles. After all, "Think thrice, measure twice, and suture once," he said with a smile.

We closed the day with a visit to Shinjuku Gyoen. Cherry blossoms framed every path, and I tried some vegan desserts and matcha ice cream that felt straight out of an anime dream.

Day 6: Mount Fuji and Ginza Nights

April 6th 2025. Today was the much-awaited Mount Fuji trip. Morning rains and a broken ETC system delayed our start, but as if by magic, the clouds cleared, revealing Fuji-san in all its glory. It was like seeing a real-life postcard.

Returning to Tokyo by early evening, we took a detour to Ginza. Unlike any shopping district I’d seen before, here brands didn’t just have shops—they had buildings. It was a surreal blend of tradition and modernity, much like Japan itself.

Week One Reflections: More Than Just Surgery

As Week 1 drew to a close, I realized that this trip was turning out to be more than just an observership—it was a masterclass in humility, craftsmanship, and cultural nuance. Whether it was the precise sutures inside the OT or the deliberate calm of a tea ceremony, Japan seemed to do everything with intention.

From Tokyo’s orderly chaos to the serenity of Mount Fuji’s fleeting appearance, each day layered itself with new learnings. I came here to observe surgeries, but I ended up observing so much more—discipline without arrogance, tradition without rigidity, and excellence without noise.

Week 2 starts with a liver transplant on the schedule and the JSS Congress in Sendai right around the corner. I know now that this journey isn’t just about becoming a better surgeon—it’s about becoming a better version of myself.

And as always, the scrubs go everywhere! :D