Chun-Chieh Wang, MD

Department of Surgical Oncology,

National Taiwan University Hospital Cancer Center Branch

It has been only a week since I finished my exchange program, but I already miss my time in Chiba. These two weeks gave me a valuable chance to "recharge" from my busy clinical work in Taiwan. I learned much more than I expected. Beyond the surgical techniques and clinical knowledge, the warm memories with my new friends in Chiba are the most precious treasures I brought home.

When I first arrived at Chiba University, I was struck by the beautiful campus and the modern architecture. The ginkgo trees in autumn were particularly stunning. Under the leadership of Professor Ohtori, I felt that the orthopedic team was very united and had a great atmosphere. The morning meetings showed strong cohesion, where different specialties shared their surgical plans and results. Afterward, the team did rounds and changed dressings together. These daily meetings help everyone stay updated on all cases, even those outside their own subspecialty.

In the operating room, I observed several impressive surgeries. In the cervical team, Dr. Maki and Dr. Hozumi showed very delicate skills. They performed intradural tumor resections—a high-pressure procedure—very smoothly and calmly. A meticulous, watertight seal was achieved using DuraGen and sutures. Their dural repair technique was so secure that I have set it as the new standard for my own surgeries. Dr. Maki also shared many difficult cases with me, helping me find answers to questions that had troubled me for a long time. These lessons were truly priceless.

In the lumbar team, I watched Dr. Inoue perform a long-segment deformity correction. I was impressed by the careful preoperative planning, the precise navigation system, and the high-quality instruments. In particular, the " Crossed-band technique " for soft landing to prevent proximal junctional failure (PJF) is a great method that I plan to use in my own practice. The other doctors in the OR were also very kind; they always made sure the camera views were clear for me to see the surgical field and kindly explained the patients' information. They also took me to lunch during the break, and we had a great chat. I sincerely appreciate their hospitality.

I spent a day at Omigawa Hospital and would like to thank Dr. Shimizu and Dr. Mukaihatsu for their kindness. Since I am very interested in endoscopy and have performed many such surgeries, I was amazed to see Dr. Shimizu use endoscopy for anterior spine surgery and OPLL treatment. This technique is rarely seen in Taiwan. Using endoscopy for OPLL has great potential and is very fascinating. Dr. Shimizu’s skills in treating lumbar and foraminal stenosis were also excellent. I was so interested that I stayed until very late. I especially want to thank Dr. Mori from the cervical team for driving me to Omigawa and staying late with me.

Thanks to Dr. Mizutani for driving me to Seirei Sakura Hospital, where I observed adult spinal deformity (ASD) surgeries. I know from experience that these cases are very difficult because of osteoporosis, stiffness, and the risk of complications like PJK or PJF. It was impressive to see Dr. Kotani, Dr. Iijima, and Dr. Minami handle these tough cases as if they were routine. Following thorough anterior and posterior releases, Dr. Iijima and Dr. Minami utilized the translation technique for correction. Unlike the forceful maneuvers I often encounter in these surgeries, the entire procedure remained smooth and gentle throughout. It was a testament to how technical excellence and efficient teamwork can make complex work look effortless. The surgery finished early in the afternoon. That night, the team took me to an Izakaya. Even though I was only there for a day, they treated me like an old friend. It was a very warm and happy memory.

This trip was a full harvest for me. I felt everyone’s hospitality and warmth. I want to thank everyone who took care of me, planned my trip, and shared their experience. Special thanks to Dr. Hirasawa for coordinating my stay, Dr. Hozumi for the itinerary, and Dr. Mizutani and Dr. Yamagata for the delicious dinner and for teaching me about Chiba’s culture.

Most importantly, I want to express my deepest gratitude to Dr. Yoh. He is the driving force behind this exchange program. Thank you, Dr. Yoh, for your generous support and for maintaining this connection. This opportunity allowed me to grow and make many new friends. I will carry on Dr. Yoh’s spirit and do my best to keep the friendship between Chiba University and National Taiwan University strong forever.

I was truly moved by the kindness and warm welcome I received from everyone throughout this journey. This trip was a great chance for me to step away from my busy schedule in Taiwan and refresh my mind. Seeing the amazing work of such skilled surgeons has given me new energy and inspiration. I am sure that the lessons I learned here will help me improve my surgical skills and provide better care for my patients in the future.

Yu-Yi Huang

Division of Joint reconstruction

Department of Orthopedic Surgery

Chang Gung Memorial Hospital, Keelung Branch

From December 1 to December 14, I had the opportunity to participate in a fellowship at Chiba University Hospital. This was my first overseas training experience, and I truly feel very fortunate that it took place at such a distinguished institution. Prior to coming to Japan, I had heard several senior colleagues share their experiences with this program, which made me both nervous and excited. After these two weeks, I can confidently say that the experience was extremely rewarding.

The use of the direct anterior approach (DAA) in total hip arthroplasty (THA) has become a clear and growing trend. I was very fortunate to observe a large number of THA procedures at both Chiba University Hospital and Funabashi Orthopedic Hospital. The surgical teams demonstrated extensive experience and well-established techniques, which helped me realize that this approach is not as difficult as I had initially imagined. Through direct observation and in-depth discussions, many of my questions regarding DAA were clarified.

In addition, robotic surgery represents another important trend in modern hip arthroplasty. At Oyumino Central Hospital, I observed Mako robotic-assisted THA. With computer assistance, the procedure allows for more efficient use of operative time, more accurate component positioning, and reduced soft tissue damage. What impressed me most was the extremely detailed preoperative planning, which plays a critical role in preventing unnecessary complications and is truly worth learning from. These experiences have significantly strengthened my confidence in my future clinical practice.

During these two weeks, I also had many opportunities to communicate with the physicians at Chiba University Hospital. Through these conversations, I became more aware of the differences in lifestyle, work patterns, and healthcare systems between our countries. Each system has its own strengths and limitations, and there were many aspects worthy of reflection and learning. Without this program, I would likely never have gained such firsthand understanding.

From my personal perspective, the schedule during these two weeks was not exhausting but highly fulfilling. I was able to gain valuable clinical insights and also had time to review recent literature from the past two years to better understand current global trends. This program allowed me to rediscover my original passion for orthopedics and provided a meaningful opportunity to step back from the fatigue caused by a busy clinical workload and reflect on my future direction.

Finally, I would like to sincerely thank everyone for their kind support and thoughtful arrangements throughout these two weeks. The outstanding surgical demonstrations, as well as the warm and memorable dinners, were truly unforgettable. I am especially grateful to Dr. Ohtori for providing this valuable opportunity, and to Dr. Yoh for the insightful and sincere discussions that helped us better understand ourselves and reflect on future career planning. I would also like to express my heartfelt appreciation to Dr. Hirasawa and Dr. Yamagata for their generous support in every aspect. We sincerely welcome all of you to visit Taiwan for academic exchange and travel in the future.