Robotic Cystectomy for Bladder Cancer: Procedure, Benefits, and Recovery

What Is Robotic Cystectomy?

Consider robotic cystectomy as a technologically advanced version of standard bladder removal surgery. It is nothing but a usual radical cystectomy, but instead of using a longer incision, it involves the use of robot-assisted tools to perform the surgery more precisely. Here is how it operates: The physician controls the movement of small, ultra-precise instruments through the small incision in the abdomen by controlling a robotic system in the console. These ultra-precise instruments will have a camera attached to them, which helps the physician have a clear view of the soft tissues. These robotic arms move more accurately than human hands, reducing the surrounding tissue damage.

Why choose robotic cystectomy over standard radical cystectomy? It’s fascinating that robotic cystectomy is associated with less blood loss, reduced scarring, and faster recovery. If cancer has spread to other parts of the bladder, then robotic partial cystectomy can be considered. However, most bladder cancer requires a radical cystectomy.

How Is Robotic Cystectomy Performed?

Before the operation begins, you will be given a general anesthetic agent to ensure that you are pain-free throughout the process.

• Firstly, your abdomen is inflated with carbon dioxide to give some room for the physician to work.

• Then, instead of making a single long cut, tiny keyhole-sized incisions are made in the belly, which allow long, precise instruments, including high-magnification cameras, to enter the abdominal cavity. You have to understand that the robot does not do the procedure. But the surgeon operates the robotic equipment through a surgical console.

• To get the best outcome, your physician removes the bladder, surrounding organs, and nearby lymph nodes. If needed, your physician may reconstruct the urinary tract. We should also know that a few physicians prefer to perform this surgery using the traditional method, which involves making a small incision or a cut near your belly button. While others use a robot-assisted method to keep the entire procedure minimally invasive. And these days it’s becoming increasingly popular.

What's the outcome? Greater precision, reduced scarring, and a smoother recovery!

What Are the Benefits of Robotic Cystectomy?

With great pride, we can say that robotic cystectomy offers several benefits over conventional radical cystectomy.

Let us look into the benefits of robotic cystectomy -

• The robotic system provides a high-definition, three-dimensional picture of the operative site.

• Also, robotic wrists allow more precise movements than human hands.

• Since it is a minimally invasive procedure, your recovery after the surgery will be quicker and does not require an extended hospital stay.

• The procedure involves making teeny tiny incisions, or keyholes, which reduces bleeding and pain. This, in turn, reduces the need for pain medications.

• Since the incisions are small, minimal scarring is seen. Now that's a relief!!

Robotic cystectomy integrates modern technology with real-world surgical skills to provide the best potential outcome while minimizing risks. Is that an ideal situation?

What Are the Risks of Robotic Cystectomy?

Here’s the not-so-good part. Like any other major surgery, cystectomy has its complications. But you will have a team of doctors to protect you from these complications, and it is always good to be aware of them.

Some of the risks of robotic cystectomy are

• Bleeding.

• Infection.

• Clotting of blood.

• Damage to the nearby structures.

What Kinds of Radical Cystectomy Procedures are Performed?

So far, you have learned about robotic cystectomy, how it is performed, its benefits, and its risks. Now, let us discuss the other types of bladder removal surgical techniques. Radical cystectomy is a procedure performed to treat bladder cancer.

The different types of procedures performed are -

• Open Cystectomy - This is a traditional method where the surgeon makes a large incision between your belly button and the pelvic bone to remove the entire bladder and surrounding lymph nodes.

• Minimally Invasive Cystectomy—In this procedure, your physician will make five to six incisions in your abdomen using a laparoscope. A laparoscope has a thin, flexible tube and a camera with light for better visibility of the inner part of the organ. These tools are then inserted through the incisions to proceed with the surgery.

• Robot-Assisted Cystectomy—In this procedure, precise, long instruments are inserted through small incisions or tiny holes and controlled by the robotic system by your doctor.

What Are the Steps Involved in the Radical Cystectomy Procedure?

Let us first discuss the steps involved before the surgery-

• Before the surgery, you will discuss your overall health condition and any diseases that may impact the surgery.

• You should inform your doctor if you have any allergies to drugs, are currently taking any medications, or have had any surgical procedures before.

• Also, if you have the habit of smoking, inform your doctor and stop smoking, as it may interfere with anesthetic medications.

Now, let’s move on to the steps during the surgery.

• A group of doctors, including anesthesiologists, urologists, and nurses, experts in various specialties, will perform the surgical procedure.

• An anesthesiologist will give you an anesthetic medication. This helps you not to feel pain and lets you sleep during the procedure.

• In robotic cystectomy, the doctor will make a few tiny incisions in your abdomen. Long and thin instruments with a camera attached at one end are inserted through these cuts. Then, your physician controls them from the control center called the surgical console.

• Your surgeon operates the robotic tools to remove the bladder and surrounding structures if necessary.

• After the bladder is removed, urinary tract reconstruction is also performed during the procedure, either by traditional methods or with robot-assisted tools.

• Urinary tract reconstruction is performed when the bladder is completely removed. It helps store and eliminate urine from the body and includes an ileal conduit, a neobladder, or continent cutaneous diversion.

Now, we are at the end of the procedure. The steps include-

• The tiny incisions are sutured and protected with bandages to avoid any infection.

• Vital signs are monitored while you recover from anesthesia.

So, once the procedure is completed, you will be monitored by a team of doctors. You will also receive instructions that you must follow after you go home from the hospital.

What Are the Risks Associated With Robotic Cystectomy?

Some individuals may experience certain risks after the radical cystectomy procedure. It includes -

• You may experience bleeding in the surgical site.

• You may also notice blood clots.

• You may sometimes experience complications associated with anesthesia.

Conclusion

So far, we have learned what robotic cystectomy is, how it is performed, and the various steps involved. The robotic cystectomy procedure is very precise and poses fewer risks when compared to standard methods of cystectomy. Suppose you are diagnosed with bladder cancer and are not sure about your treatment plan. In that case, you can seek advice from iCliniq doctors who can guide you on various treatment approaches available to treat bladder cancer.

Key Takeaway/Note from Icliniq:

Once the robotic cystectomy procedure removes the bladder, urinary flow is restored by urinary diversion. It includes neobladder, ileal conduit, or continent diversion. It will take some time for your body to adapt to these changes. Certain lifestyle changes help you to live a good quality of life after a robotic cystectomy. If you face any complications after surgery, get help from your doctor without hesitation.