Today, I learned of the passing of Dr. Hiromi Shinya, who died in Tokyo, Japan on December 9, 2021. Dr. Shinya was a pioneer of colonoscopic techniques, the inventor of the electrosurgical polypectomy snare, which allowed for the removal of colon polyps without the need for invasive surgery. This is a deeply personal loss, as I will explain.

As Wikipedia tells us:

Hiromi Shinya was born [on March 6,] 1935 in the city of Yanagawa in Fukuoka Prefecture, Japan. … From a young age, his mother … encouraged him to earn a medical degree and pursue medicine in the United States. He graduated from Juntendo University School of Medicine in 1960. He then applied with nine hundred other candidates for one of fourteen openings for interns at the United States Naval Hospital in Yokosuka. Passage of the Educational Commission for Foreign Medical Graduates examination was required for the program, necessitating a high degree of English fluency, so he “spent a lot of time going to American movies” to prepare. He married Miyoko Mogi on March 6, 1963. She was a nurse on the Yokosuka Naval base. She graduated from Tokyo University nursing school.

Following his internship, Dr. Shinya would go on to complete a surgical residency at Beth Israel Medical Center, becoming involved in a revolutionary new technique in gastrointestinal medicine: endoscopic and colonoscopic procedures. From Wikipedia:

Shinya began developing colonoscopic techniques with an esophagoscope from Olympus Optical Co., Ltd.. The instrument was a short fiberscope with a two-way maneuverable tip and was designed for use on the esophagus, but with it, Shinya was able to reach the splenic flexure—the first bend in the colon—about 50% of the time. While other doctors were concurrently developing colonoscopic techniques, most of them practiced a two-person technique, with one person controlling the direction of the tip while the other controlled insertion. Shinya was in the minority who rejected this procedure, preferring to develop methods which allowed one endoscopist to perform colonoscopy reliably. As a result, “many and probably most of the fundamental principles of the procedure were developed by Dr. Shinya”. By the beginning of 1969, Olympus had introduced several iterations of dedicated colonoscopes, and Shinya was able to reach the cecum—located at the end of the colon—in 90% of his patients. Shinya’s other major contribution to colonoscopy was the invention of the electrosurgical polypectomy snare, known as the “Shinya snare” with the support of Olympus employee Hiroshi Ichikawa. Even before the results of the National Polyp Study linked colon polyps to colon cancer, Shinya instinctively “thought the polyp was the forerunner of cancer and that removing these polyps could reduce the risk of cancer”. Since polyp removal accounted for 30% of the colon surgery of the day, Shinya’s primary focus from his first experiences with colonoscopy was a noninvasive method of performing polypectomy. On January 8, 1969, he and Hiroshi Ichikawa sketched out the first plans for a snare attached to the end of a colonoscope that would allow for easy removal of polyps during colonoscopy. … Shinya … performed the first colonoscopic electrosurgical snare polypectomy in September 1969. In 1970, he delivered the first report of the procedure to the New York Surgical Society, and in May 1971 presented his experiences to the American Society for Gastrointestinal Endoscopy.

This development made Shinya famous worldwide. There was immediate demand for his procedure, with his performing 20 colonoscopies a day. To date, he has performed approximately 370,000 colonoscopies and given nearly 300 live demonstrations of the technique. Polypectomy has gone on to surpass “all other endoscopic therapeutic procedures in terms of numbers performed” and “impacts the lives of millions of people throughout the world.” According to Michael Sivak Jr., it is the most important achievement in gastrointestinal endoscopy.

I can testify personally to the greatness of this man. I spent the bulk of my childhood deathly sick, and despite countless tests from scores of doctors, not a single doctor could come up with a diagnosis for the extreme intestinal symptoms I was experiencing—even as I was, essentially, withering away. By the time I was 13 years old, I was around 60 lbs.

Only my family doctor, Dr. Harry Karounos, was convinced—after performing a GI series in his own office (yes, they did that back then)—that it might be suppression of the duodenum caused by the Superior Mesenteric Artery. There was no way to get confirmation of this extremely rare condition known as Superior Mesenteric Artery Syndrome, a condition not clinically described until 1861, and not fully defined until 1927. There had only been a reported 400 congenital cases of SMAS in the literature (other acute cases related to body casts, have been diagnosed since, including one related to the spinal injury suffered by Christopher Reeve). The condition is so rare that it wasn’t until 2017 that a not-for-profit organization was founded to heighten awareness of it: Superior Mesenteric Artery Syndrome Research Awareness Support. In October of that same year, only “The Good Doctor”, in the second episode of its first season, featured a story in which a young girl nearly dies from it.

Back in 1973, we were extremely fortunate to have learned of the revolutionary new techniques in endoscopic medicine being performed by Dr. Shinya. We were able to schedule an esaphagogastroduodenoscopy, which Dr. Shinya performed on me, in his office, under sedation. In 20-30 minutes, Dr. Shinya provided a conclusive SMAS diagnosis. A few months later, on April 21, 1974, at Methodist Hospital, in Brooklyn—the hospital in which I was born in 1960—I was reborn, when Dr. Joseph Bochetto performed a major surgical duodenojejunostomy, by-passing the obstructed third and fourth portions of the duodenum. (There were no laproscopic surgical techniques available at the time.)

In the years since, I developed quite a few complications due to the by-pass surgery. I’ve had 60+ procedures since, all in some way related to the condition and its postoperative side effects. I discussed this condition in a Folks interview back in 2018, and in Notablog entries in January 2018 related to it.

But I am alive—and flourishing—to talk about. I have lived a happy, loving, and productive life, and I simply would not be here if it were not for Dr. Shinya. I mourn his passing, but I celebrate his life. He remains one of the greatest healers to have ever graced this planet. He was also a gentle man, a beautiful soul who was a source of enormous comfort—and hope—anytime you were in his caring presence.

There is an age-restricted video of Dr. Shinya performing a colonoscopy (not for the faint of heart) on YouTube; at his side in the video is his protégé, my current doctor: Dr. Mark Cwern. I thank Dr. Shinya not only for having saved my life, but for having provided me with the gift of Dr. Cwern, who has been by my side for many years, a man who has carried on the legacy of Dr. Shinya with enormous integrity and kindness.

Unfortunately, I have not found a single obituary to mark the passing of this giant in the field of gastrointestinal medicine. To his family, friends, and colleagues, I offer my deepest condolences. To the hundreds of thousands of people whose lives he personally saved, to the many millions of people whose lives have been saved due to the enormous contributions he has made, I dedicate this tribute. Thank you, dearest doctor, for all that you did for me. Rest in peace.