"Shaping the Future with Microsurgery"

Today, we bring you an inspiring interview with Prof. Isao Koshima, a pioneer in microsurgery renowned for groundbreaking advancements in lymphaticovenous anastomosis and innovative surgical techniques. In this exclusive conversation, Prof. Koshima shares his journey, the pivotal role of tools like CROWNJUN's 50μm sutures in clinical excellence, and his forward-thinking vision for the future of microsurgery

 

【About Prof. Isao Koshima】
Prof. Isao Koshima graduated from Tottori University in 1976. He began his academic career as a professor of Plastic and Reconstructive Surgery at Okayama University in 2000, later becoming a professor of Plastic and Aesthetic Surgery at the University of Tokyo in 2004. Since 2017, he has served as a Specially Appointed Professor and Director of Plastic Surgery at the International Lymphedema Treatment Center, Hiroshima University Hospital.
Prof. Koshima remains actively engaged in surgeries and lectures, with expertise spanning super-microsurgery, lymphedema, and facial nerve paralysis. Renowned for his numerous international lectures and collaborations, he has played a pivotal role in advancing the field of microsurgery and sharing his groundbreaking techniques with professionals worldwide.

 

– What inspired you to pursue microsurgery?

 –"It Was Simply Fascinating"

My introduction to microsurgery came in the fall of 1977. At that time, our facility had just begun performing free flap surgeries, and our department created an environment conducive to practicing microsurgery—a factor that made a tremendous difference. Once I started, I found it absolutely captivating. After completing my daily work, I would dedicate about five hours each evening to practicing microsurgery, often until 11 p.m. or midnight.
For me, it didn’t feel like "practice" in the traditional sense—it was pure enjoyment. I became so immersed in the process that, before I realized it, I had honed my skills in various techniques, including perforator flap surgery and lymphaticovenular anastomosis. Reflecting on those evenings now, I see how the joy of those countless hours of practice laid the foundation for my career.
It was during this period that I first encountered CROWNJUN (Kono Seisakusho). The introduction came when they presented me with their exceptional 50μm suture needle. Up until then, I had been using a similar needle from another company, but CROWNJUN's needle had an ideal length and was significantly more user-friendly. After transitioning to CROWNJUN's needles, I noticed marked improvements in clinical outcomes.
This experience solidified my belief that achieving excellent surgical results requires not only refined skills but also the finest tools. It also ignited a deep interest in the development of surgical instruments, which continues to inspire me to this day.

 

 

– What potential does microsurgery hold for the future?

–”From Treatment to Prevention”

Initially, perforator flap surgery faced some hesitation in Japan. However, collaboration with many overseas surgeons helped to refine and advance the technique. These partnerships not only fostered enduring relationships with surgeons worldwide but also attracted aspiring microsurgeons from across the globe who sought guidance. These interactions have provided me with invaluable opportunities to envision the future of microsurgery on a global scale.

What excites me most at present is the potential of robotic surgery. I am confident that once these technologies become clinically accessible, microsurgery will see broader adoption. Consider the example of lymphaticovenular anastomosis (LVA), a procedure I frequently perform. Currently, LVA is conducted as a separate surgery following cancer resection to treat lymphedema, a common postoperative complication. With robotic surgery, however, gynecologists could integrate microsurgical techniques into their cancer resection procedures, allowing LVA to be performed simultaneously. This shift could lead to a greater emphasis on “preventive surgeries,” addressing complications before they occur.

In the realm of regenerative medicine, the potential is equally vast. If microsurgical techniques could be employed to connect the ultra-fine blood vessels that nourish cultured cells, we could significantly enhance current flap procedures. This would minimize the need to create additional wounds for tissue harvesting.

Furthermore, robotic microsurgery’s precision offers opportunities to expand its applications into domains invisible to the naked eye, paving the way for interventions at the cellular and even genetic levels. Such innovations have the potential to revolutionize how we address medical conditions, fundamentally improving patient outcomes and redefining the boundaries of modern medicine.

 

 

– What advice would you give to aspiring microsurgeons?

–“A Collective of Master Craftsmen”

I firmly believe that microsurgery, with its vast potential, will play a crucial role in shaping the future of the medical field. As reconstructive surgeons, we are no longer in an era where focusing solely on our own specialty is enough. It’s essential to broaden our horizons by exploring other fields, understanding advancements in genetics, and delving into the possibilities of engineering technologies. Expanding one’s knowledge across disciplines is key to fostering innovation.

Through my own experience, I’ve come to realize that having an environment conducive to learning is indispensable for skill development. I hope that CROWNJUN will continue to nurture such an environment, enabling young physicians to take on the challenges of microsurgery with confidence and without hesitation.

In recent years, the issue of sexual dysfunction following cancer treatment—once considered a taboo topic—is now being openly discussed. The focus has shifted beyond simply curing diseases to ensuring that patients can lead fulfilling lives after treatment. Achieving this goal requires not only technological innovations, such as robotics, but also continuous improvements in the quality of patient care.

In this context, I believe that surgeons must work together as a “collective of master craftsmen,” constantly refining their skills. While robotics provides unparalleled precision, it is human ingenuity that can wield such technology effectively, using it as a springboard to push the boundaries of medical science.

From the moment I used CROWNJUN’s 50μm suture needle, I recognized them as a group of dedicated craftsmen, much like surgeons themselves, who take immense pride in their technical expertise. Together, we must continue to refine our craft and pass on our knowledge to create a brighter future for patients. I hope that CROWNJUN will remain a vital partner in this journey, innovating and excelling in their craft to help shape the future of the medical field.

 

 

Prof. Koshima’s profound insights into microsurgery’s potential, combined with his unwavering dedication to advancing medical science, continue to inspire surgeons and researchers globally. His collaboration with partners like CROWNJUN highlights the synergy between skill, technology, and innovation needed to shape the future of healthcare.

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