Robotic Radical Cystectomy

Overview of Robotic Radical Cystectomy

A robotic radical cystectomy is the removal of the whole bladder and possibly nearby tissues (including lymph nodes) and organs. For men, the prostate and urethra also may be removed.

For women, the uterus, fallopian tubes, ovaries and part of the vagina may be removed. It is most commonly used in the treatment for bladder cancer. This procedure may be used along with chemotherapy and/or radiation therapy, depending on the stage, size and location of the cancer.

Robotic-assisted equipment and technology allows our urologic specialists, including laparoscopic and robotic surgeons, anesthesiologists and operating room technicians to perform surgery with greater control and flexibility.

Operating through small incisions, movements by the surgeon's hand or wrist are translated into highly precise movements of the robot’s surgical instruments.

Why Choose Loyola for Robotic Radical Cystectomy?

Loyola Medicine’s urologic cancer treatment specialists implement the latest technology in state-of-the-art facilities to diagnose and treat bladder cancer.

At Loyola, an interdisciplinary team of experts works together to provide you the most comprehensive treatment, resulting in the best outcomes for your condition.

Loyola is a world-class academic medical center, and our clinical activities are enhanced with our vigorous approach to research. Our clinicians and medical researchers collaborate to better understand the growth and development of bladder cancer so we can ensure the most positive outcomes for our patients.

What to Expect with Robotic Radical Cystectomy

During the robotic radical cystectomy procedure, the patient is given anesthesia and remains unconscious for the duration of the surgery. The surgeon makes several small (laparoscopic) incisions in the abdomen from a remote control console next to the operating table.

A telescopic lens is inserted into one of these small holes, enabling the surgeon to see a magnified, 3D view of the area surrounding the bladder. They is able to precisely control movements of the robot’s surgical instruments to remove the bladder and surrounding cancerous tissue through intuitive technology that translates movements from his/her hand and wrist to the robotic instruments.

The bladder and pelvic lymph nodes are then removed through one of the small incisions.

Because this procedure removes the entire bladder, urinary reconstruction is needed to create a new means of urinary expulsion. Techniques to reconstruct the urinary tract can be performed robotically and include:

• New bladder (neobladder) – A neobladder is a substitute for the natural bladder. It is made from the patient’s intestine and connected to the urethra, allowing the urine to drain in a relatively normal manner.
• Continent urostomy – This surgical procedure places a pouch inside the body, which acts as an artificial bladder to store urine. The urine is emptied on a periodic schedule from the pouch through a catheter that is inserted into a small opening, often on the lower abdomen.
• Incontinent urostomy – This surgical procedure inserts a bag outside of the body. Urine flows into the bag from a catheter, which is emptied periodically.

The robotic radical cystectomy procedure typically results in less pain and blood loss, a shorter hospital stay (four to seven days) and faster recovery time than traditional, open surgery. Patients are usually able to return to normal urine control within one to three months.

Risks of Robotic Radical Cystectomy

Complications post-surgery of robotic radical cystectomy are rare, especially as compared to the associated risks of traditional, open cystectomy procedures.

Risks to consider include:

• Bleeding
• Fistula
• Urgent need to urinate
• Erectile dysfunction
• Incontinence
• Urinary tract infection
• Infection