玉手　雅人

写真a

所属

医学部 産婦人科学講座産婦人科学分野

職名

講師
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  • 2003年
    -
    2009年

    札幌医科大学   医学部   医学科  

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  • 札幌医科大学   医学博士

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  • 2025年02月
    -
    継続中

    札幌医科大学   産婦人科学講座  

  • 2024年06月
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    2025年01月

    Baylor University Medical Center   Transplantation (Uterus Transplantation)   Reseacher

  • 2024年05月
    -
    2024年06月

    広島大学 消化器・移植外科  

  • 2024年03月
    -
    2024年05月

    藤田医科大学 臓器移植科  

  • 2015年10月
    -
    2024年03月

    札幌医科大学   産婦人科学講座   助教

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  • ライフサイエンス   産婦人科学  

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  • 札幌医科大学   産婦人科学講座   講師  

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研究キーワード 【 表示 ／ 非表示 】

  • 婦人科腫瘍、子宮移植

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  • Outcome and Surgical Technique of Robot-assisted Living Donor Hysterectomy for Uterus Transplantation.

    Masato Tamate, Giuliano Testa, Laura Divine, Liza Johannesson

    Journal of minimally invasive gynecology    2025年03月  [国際誌]

    DOI PubMed

  • Standardization of back-table technique for uterus transplantation.

    Masato Tamate, Giuliano Testa, Johanna Bayer, Liza Johannesson

    Fertility and sterility    2025年02月  [国際誌]

    　概要を見る

    OBJECTIVE: To present a standardized back-table technique for uterus transplantation (UTx). DESIGN: Step-by-step description of surgical technique and live-action narrated surgical footage showing back-table technique in UTx. SUBJECTS: Uterus transplantation has become a viable option for patients with absolute uterine factor infertility and their families. After performing 20 research cases, our institution has conducted UTx in 13 patients, and over 100 cases have been performed worldwide. Uterus transplantation is now considered technically feasible, with a high live birth rate after successful graft survival. INTERVENTION: The transplantation of a uterus involves three separate surgical components: living or deceased uterus retrieval; back-table preparation of the uterine graft; and implantation of the uterine graft in the recipient. The living donor hysterectomy and implantation of the uterus in the recipient can be seen in separate videos. The back-table process is critically important in transplant surgery. After the uterus is removed from the donor, organ perfusion, vascular preparation, and marking are essential for ensuring a smooth transition to recipient surgery. In this video, we demonstrate our standardized back-table technique. Currently, there are no articles in gynecology focused solely on back-table techniques. When selecting a potential donor, factors such as age, body mass index, general health, and obstetric and surgical history are considered. Once a candidate is deemed suitable, in-person screening includes blood tests, imaging studies, and mental health evaluations. Preoperative imaging provides valuable information on the condition of the uterine vascularity, which is crucial given the complexity and variability of pelvic vessels. Once the uterus is removed from a living or deceased donor, it is immediately placed on ice and flushed with cool preservation fluid on the back-table. Back-table procedures average 0.5-1 hours and includes the following: perfusion; preparation of the arteries; preparation of the veins; ligation of the base of the fallopian tubes; and four-point suturing of the vagina, as well as (optional) cervical cerclage. Preparing the veins is a key part of the back-table process, especially when the vessel diameters are small, necessitating conjoining. Additionally, because the uterus is a mobile organ located between the bladder and rectum, it is essential to assess the shape and positioning of the vessels that will be anastomosed to avoid torsion during the uterine-vessel anastomosis. We believe that our method will be useful for many institutions that wish to initiate UTx programs. MAIN OUTCOME MEASURES: Uterine graft viability and recipient pregnancy outcome. RESULTS: No surgical complications occurred. The postoperative course was uneventful, with early mobilization. The length of hospital stay was 5 days. The uterus was successfully implanted with successful pregnancy outcome. CONCLUSION: Our standardized back-table technique minimizes harm to the recipient. Furthermore, the technique does not compromise the uterine graft function. Further studies and more educational content using video will be key to the widespread adoption of uterine transplantation.

    DOI PubMed

  • Standardization of recipient surgery for uterus transplantation.

    Masato Tamate, Liza Johannesson, Johanna Bayer, Giuliano Testa

    Fertility and sterility    2025年02月  [国際誌]

    　概要を見る

    OBJECTIVE(S): To present a standardized surgical technique of recipient transplant surgery for uterus transplantation (UTx). DESIGN(S): Step-by-step description of surgical technique and live-action narrated surgical footage showing uterus recipient surgery in UTx. SUBJECT(S): Uterus transplantation can become a standard option for patients with absolute uterine factor infertility and their families (1, 2). Thirty-six uterus cases of UTx have been performed at Baylor University Medical Center in Dallas (January 2025). Most uterus recipients to date have a congenital absence of the uterus (Mayer-Rokitansky-Küster-Hauser syndrome [MRKH]). Our team has established standard methods for donor surgery and uterine graft back-table techniques. Because the uterus recipient surgery is typically performed using an open approach, high-quality educational videos of UTx are scarce. To aid institutions interested in initiating UTx, an educational video demonstrating our standardized recipient surgery is essential. This video shows the surgical procedure in a 39-year-old previously healthy woman with MRKH. The vascular nomenclature recommended by the United States Uterus Transplant Consortium is used in the manuscript (3). INTERVENTION(S): Uterus transplant recipient surgeries are performed via laparotomy and are significantly shorter than the living donor hysterectomies, averaging 4-5 hours (4). The operative steps performed are as follows: 1) exposure of the external iliac vessels; 2) exposure of the vaginal anastomosis site; 3) graft implantation and vascular anastomosis; 4) vaginal transection and anastomosis; and 5) fixation of the uterus and ovaries. Steps 1-2 are performed jointly by the gynecology surgeon and transplant surgeon; step 3, involving the anastomosis of blood vessels, is conducted by the transplant surgeon. Although steps 1, 2, 4, and 5 are not particularly challenging for an experienced gynecologic oncology surgeon, the vascular anastomosis in step 3 is delicate. This anastomosis involves suturing blood vessels smaller than those used in kidney and liver transplants, using 7-0 monofilament for the arterial and 8-0 monofilament for the venous anastomosis. After reperfusion of the uterine graft, the vaginal anastomosis is completed, which is where most of the bleeding occurs during surgery. For this step (step 4), we use continuous suturing from the 3 to 9 o'clock positions. The vaginal approach is preferred because of the challenging anatomy, particularly in patients with MRKH, where the foreshortened vagina lies deep in the pelvis. Continuous sutures are used for hemostasis in the posterior vaginal wall, where venous blood flow is abundant. To attempt prevention of vaginal structuring, the anterior vaginal wall is sutured interrupted. Step 5 includes fixation of the uterus and ovaries. A trained gynecology surgeon is essential, because the technique may vary depending on the condition of the patient with MRKH. Before implantation of the uterine graft in the recipient, the uterus is removed from a living or deceased donor and subsequently placed on ice and flushed with cool preservation fluid on the back table. The back table is a sterile area used in transplantation surgery where the organ is prepared for transplantation. Preparation includes trimming and potential 86 reconstructions of the vessels that will be used. The living donor hysterectomy and the back table procedure can be seen in separate videos. MAIN OUTCOME MEASURE(S): Hospital stay, perioperative, and long-term complications. Uterine graft viability and recipient pregnancy outcome. RESULT (S): No surgical complications occurred. The postoperative course was uneventful, with early mobilization. The length of hospital stay was 5 days. The uterus was successfully implanted with a successful pregnancy outcome. CONCLUSION(S): Our standardized uterus recipient surgery technique minimizes harm to the recipient. Furthermore, the technique does not compromise the uterine graft function and pregnancy outcome. Further studies and more educational content using video will be key to the widespread adoption of uterine transplantation.

    DOI PubMed

  • Standardization of robot-assisted living donor hysterectomy for uterus transplantation.

    Masato Tamate, Laura Divine, Giuliano Testa, Liza Johannesson

    Fertility and sterility    2025年02月  [国際誌]

    　概要を見る

    OBJECTIVE: To present a standardized surgical technique of robot-assisted living donor hysterectomy for uterus transplantation with preservation of the donor ovaries. DESIGN: Step-by-step description of surgical technique and live-action narrated surgical footage showing uterus donor hysterectomy. SUBJECTS: Nineteen robot-assisted living donor hysterectomies for uterus transplantation have been performed at Baylor University Medical Center at Dallas (September 2024). This video shows the surgical procedure in a 33-year-old previously healthy woman. She had a history of a unilateral laparoscopic ovarian cystectomy, and her obstetric history included three term vaginal deliveries. She independently contacted our institution expressing interest in becoming a nondirected uterus donor and underwent comprehensive evaluation by a multidisciplinary transplant team, including medical and psychological assessment for suitability to donate. She explicitly stated desire for no further children. INTERVENTION: Robot-assisted living donor hysterectomy using the da Vinci Xi robotic system. Surgery was performed with the patient in Trendelenburg position (15°), using CO2 pneumoperitoneum (<12 mm Hg), with a four robotic-arm arrangement. Ureteric stents were placed bilaterally, and indocyanine green was injected retrograde to facilitate ureter identification using firefly mode during dissection. Retraction of the uterus was performed with a uterine manipulator. The operative steps performed were as follows: ligation of the round ligaments and exposure of the retroperitoneal space; dissection of the superior uterine veins; dissection of the uterine arteries and the inferior uterine veins; dissection of the ureters, bladder, and rectum; vaginotomy and transection of the vessels; transvaginal uterine graft extraction using a Endo Catch retrieval system and closure of the vaginal cuff. Anatomical terms are used in the video and narration with reference to common gynecological practice. After removal of the uterus from the donor, the uterus was placed on ice on the back-table and flushed with cool preservation fluid. The back-table is a sterile area used in transplantation surgery where the organ is prepared for transplantation. Preparation includes trimming and potential reconstruction of the vessels that will be used. It is on the back-table where the final decision to go ahead with the transplant surgery is made by the uterus transplant team. The back-table procedure and implantation surgery can be seen in separate videos. MAIN OUTCOME MEASURES: Hospital stay, perioperative and long-term complications, uterine graft viability, and recipient pregnancy outcome. RESULTS: No surgical complications occurred. The postoperative course was uneventful, with early mobilization. The length of hospital stay was 2 days. At a 1-year follow-up, the donor reported no concerns and sexual activity without complications. The uterus was successfully implanted to a recipient with successful pregnancy outcome. CONCLUSION: Our standardized robot-assisted living donor hysterectomy technique represents a safe approach to minimize donor harm and allows for preservation of the donor ovaries. Furthermore, the technique does not compromise the uterine graft function and pregnancy outcome.

    DOI PubMed

  • Human papillomavirus self-sampling and urine-sampling tests and the management and short-term outcomes of cervical intraepithelial neoplasia: A prospective observational study.

    Motoki Matsuura, Masato Tamate, Sachiko Nagao, Taishi Akimoto, Fukiko Kasuga, Kimihito Saito, Satoshi Shikanai, Yoko Nishimura, Mizue Teramoto, Tsuyoshi Saito

    The journal of obstetrics and gynaecology research   50 ( 10 ) 1801 - 1807  2024年10月  [国際誌]

    　概要を見る

    AIM: The importance of human papillomavirus (HPV) co-testing using physician-, self-, and urine-collected samples to predict cervical intraepithelial neoplasia (CIN) grade 1-2 prognoses has not been previously reported. Therefore, this study aimed to investigate outcomes of patients with CIN 1-2 who simultaneously underwent physician-, self-, and urine-collection sampling tests. METHODS: This study was conducted in Japan between October 2019 and November 2022 and examined the proportion of cases with CIN 1-2 progressions, the percentage of cases with persistent CIN 1-2, and the outcome differences according to the results of physician-, self-, and urine-sampling tests. RESULTS: There were 105 and 59 CIN 1 and 2 cases, respectively, with progression or persistence in 27 (29.3%) and 21 (50.0%) cases, respectively. The median follow-up was 20 and 12 months, respectively. Progression and persistence of CIN 1 were significantly associated with HPV-positive physician- and self-collected samples. No significant difference was observed between cases with CIN 2 who had HPV-positive and HPV-negative results using any sampling method. CONCLUSIONS: Physician- and self-testing for HPV are crucial for predicting disease progression risk in CIN 1 cases. Future research with an extended observation period and consideration of the progression risks is warranted.

    DOI PubMed

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  • 【エネルギーデバイス アラカルト-知っておきたい使い方の留意点と技術革新】総論 モードの特性と使い分け

    玉手 雅人, 松浦 基樹, 齋藤 豪

    臨床婦人科産科 ( (株)医学書院 )  78 ( 12 ) 1083 - 1090  2024年12月

    　概要を見る

    ＜文献概要＞●電気メスのモードと本体の使い分け:電気メスの効果と性能は,モードと出力設定で変化するが,電気メスを接続する本体の種類によっても異なる.●他の手術機器との使い分け,バイポーラ・アドバンスドバイポーラ・バイクランプの使い分け:電気メス,バイポーラ,アドバンスドバイポーラ,超音波凝固切開装置の組み合わせは術式・手技・コストで考慮する.●機械の特性を理解して,術者が自身の技量や手術スタイルに合わせてエネルギーデバイスを扱うことが重要と思われる.

  • 【エネルギーデバイス アラカルト-知っておきたい使い方の留意点と技術革新】各種デバイスの原理・有用性と使用上の注意点 シーリングデバイス

    松浦 基樹, 玉手 雅人, 齋藤 豪

    臨床婦人科産科 ( (株)医学書院 )  78 ( 12 ) 1104 - 1111  2024年12月

    　概要を見る

    ＜文献概要＞●シーリングデバイスは直径7mmまでの血管や組織束がシール可能であり,超音波凝固切開装置より太い血管をシールすることができる.●シーリングデバイスは高周波エネルギーを瞬時に供給して血管のシールを行うため,手術効率が向上するだけではなく,熱の拡散を極力抑えることで周囲の組織への影響を最小限に抑えることができる.●外科医は各デバイスの原理や有用性・注意点などを習熟したうえで,これらのデバイスを使用するべきである.

  • ロボット支援子宮全摘出術での発光式尿管カテーテルと子宮トランスイルミネーターの使用経験

    幅田 周太朗, 黒川 晶子, 有元 千紘, 長尾 沙智子, 玉手 雅人, 秋元 太志, 松浦 基樹, 齋藤 豪

    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 )  71回   78 - 78  2024年09月

  • IB3期の子宮頸癌に対して術前化学療法後に広汎子宮頸部摘出術を施行し分娩となった1例

    佐藤 冴子, 染谷 真行, 玉手 雅人, 松浦 基樹, 森下 美幸, 馬場 剛, 石岡 伸一, 齋藤 豪

    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 )  71回   48 - 48  2024年09月

  • 当院における再発子宮体癌に対するPembrolizumab+Lenvatinibの使用経験

    長尾 沙智子, 松浦 基樹, 黒川 晶子, 玉手 雅人, 秋元 太志, 幅田 周太朗, 岩崎 雅宏, 齋藤 豪

    日本婦人科腫瘍学会学術講演会プログラム・抄録集 ( (公社)日本婦人科腫瘍学会 )  66回   405 - 405  2024年07月

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受賞 【 表示 ／ 非表示 】

  • 井坂賞

    2024年06月   日本産婦人科ロボット学会  

  • 令和4年 教育奨励賞

    2022年05月   日本産科婦人科学会  

  • 優秀演題賞

    2017年09月   第65回 北日本産科婦人科学会総会・学術講演会  

  • 優秀演題賞

    2012年11月   日本臨床細胞学会  

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共同研究・競争的資金等の研究課題 【 表示 ／ 非表示 】

  • 献体に体外循環を用いて子宮移植を行うトレーニングプログラム

    基盤研究(C)

    研究期間:

    2024年04月
    -
    2029年03月
     

    玉手 雅人

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  • 2024年04月
    　
    　

      評議員

  • 2020年04月
    　
    　

      代議員

  • 2018年04月
    　
    　

      評議員

  • 2018年04月
    　
    　

      評議員

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