Hiroshi Akiyama was professor of surgery at Toranomon Hospital, Tokyo, and an internationally renowned gastro-oesophageal surgeon. He was born on 2 July 1931 in Chiba, Japan, the son of Dr Mizuki Akiyama. He studied medicine at the University of Tokyo, qualifying in 1955. He then spent a year on a rotating internship at the United States Army Hospital, Camp Zama. From 1956 to 1957 he was a surgical intern at Buffalo General Hospital, New York, on a Fulbright scholarship. He then returned to Japan, as a surgical resident in Tokyo. His postdoctoral research extended from 1975 to 1986. He investigated tumour types in oesophageal cancer, appropriate dissection of gastrointestinal cancer and techniques of gastrointestinal anastomosis. He also studied problems in bile duct reconstruction. Further research followed into improving the results of surgery for gastrointestinal malignancy in terms of survival. Some of this work was concentrated on oesophageal cancer, but gastric cancer was also incorporated. Within these studies, he looked at techniques of filming the deep surgical field, adjuvant immunochemotherapy and reconstruction techniques. Akiyami held a number of hospital appointments during his training and as a consultant surgeon. He was a clinical instructor and member of the surgical staff of Tokyo University Hospital from 1963 to 1972, consultant to the Tokyo Metropolitan Police Hospital, lecturer at the University of Tokyo and University of Tsukuba schools of medicine, and visiting professor at the Tokyo Medical College from 1986 to 2003. He was a member of 10 Japanese medical societies devoted to various gastroenterological and other cancers, and also on the editorial boards of 10 journals. Hiroshi Akiyama was an honorary member or fellow of 22 institutions in the USA, South America, Asia and Europe. He was an honorary visiting professor at 14 centres outside Japan. His writings were in Japanese and English, based on results obtained at the Toranonom Hospital in Tokyo. As far back as 1980 Richard Earlam at the London Hospital had reviewed reports of 83,783 patients with squamous oesophageal cancer and concluded that of 100 patients presenting, 58 were explored. Of these, 39 had resections performed and 26 of them left hospital. After a year, 18 had survived, but only four survived for five years. The very next year, Akiyama reported his personal series of 354 similar patients, of whom 210 had had resections. Operative mortality was 1.4% and 34.6% survived for five years! His pathological examination of the meticulously resected, plotted and studied specimens demonstrated the wide spread of cancer to glands, irrespective of the primary location. Hiroshi's attitudes ran very parallel with those of Norman Tanner, the doyen of British gastric surgeons - obsessive clearance of cancer and glands, followed by perfect apposition during reconstruction. Two young surgeons were sent from the Royal Free Hospital in London to observe him. They returned full of admiration: one was allowed to participate in the procedures. He particularly appreciated the commitment to the highest standards of performance. The second was invited to remain and help with the editing of the famous book, *Surgery for cancer of the esophagus* (Baltimore, Williams and Wilkins, c.1990). He reported that Hiroshi was as determined to achieve full and accurate reporting as he was to achieve exemplary performance of the operations. During the extended visit he found Akiyama and his wife to be wonderfully hospitable hosts. In particular, Hiroshi was quiet, unassuming, conducting himself with humility and willing to listen and to teach juniors. Those of us who had the privilege of knowing Akiyama acknowledge him as a master clinician and operator, and a major contributor, committed to excellence. He dedicated himself to his patients, to surgery and to science. Those of us who became aware of his achievements late in our careers recognised that we had been dinosaurs. Outside medicine, his hobbies were the violin and tennis. He married Kazuko Morimoto in 1958 and they had three children: daughters Mariko and Yoko, and son Futoshi, who is a plastic surgeon. Akiyama died on 21 September 2012.