Robotic Cystectomy Surgery In Bladder Cancer

Robotic cystectomy used in the treatment of bladder cancer offers patients a more comfortable recovery compared to open surgery.

What is Robotic Cystectomy Surgery?

Robotic cystectomy is a surgical method involving minimally invasive procedures performed using robotic devices for the treatment of bladder cancer. In robotic cystectomy, part or all of the bladder is removed, and if necessary, lymph nodes surrounding the bladder can also be removed during the procedure. Robotic cystectomy can be performed in two ways: partial or radical cystectomy. Radical cystectomy involves removing the entire bladder and, if necessary, the surrounding tissues from the cancerous area. Partial cystectomy involves removing only a portion of the bladder. The type of cystectomy is decided based on the cancer stage, the patient's overall health, and the patient's preferences.

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How Is Robotic Cystectomy Surgery Performed?

In bladder cancer, robotic cystectomy surgery is performed under general anesthesia using a robotic surgical instrument. Four to six small incisions are made in the patient's abdomen; one is used for the camera, while the others are for the surgical instruments. The surgeon controls the movement of the surgical instruments from the robot console, and the bladder and surrounding lymph nodes are removed. In men, the prostate and seminal vesicles may be removed, while in women, the uterus, ovaries, and part of the vagina may also be removed. After cystectomy, a suitable urinary system (urinary diversion) is created for the patient. For urinary diversion, ileal conduit (administration of urine through a stoma to the abdominal wall) or orthotopic neobladder (artificial bladder made from the intestine) methods can be preferred.

How Long Does Robotic Cstectomy Surgery Take?

The duration of robotic cystectomy surgery depends on factors such as the stage of bladder cancer, the patient's general health condition, and the scope of the cystectomy. Radical robotic cystectomy takes an average of 5-7 hours. The surgery time may be longer depending on abdominal adhesions, the extent of tumor spread, and the choice of postoperative urinary diversion.

Who Is a Suitable Candidate For Robotic Cystectomy Surgery?

Robotic cystectomy is most often performed in patients where cancerous cells have begun to spread to the muscle layer or in cases of recurrent high-risk bladder cancer. Radical cystectomy is preferred in patients where the cancer has progressed to the muscle layer. The type of cystectomy is determined depending on the stage and spread of the cancer and the patient's overall health condition.

Is Robotic Cystectomy More Advantageous Than Open Surgery?

Robotic cystectomy offers several advantages over open surgery. These include smaller incisions, less postoperative pain, less blood loss, and shorter observation periods. Open surgery is still used in some critical situations, but it results in greater bleeding, postoperative pain, and longer hospital stays.

What Is Placed In Place Of The Bladder After Robotic Cystectomy Surgery?

Urinary diversion is necessary to restore bladder function after robotic cystectomy surgery. Urinary diversion methods include:

• Ileal conduit (urostomy): The patient uses a stoma (external bag).
• Orthotopic neobladder (artificial bladder): A bladder is reconstructed from the intestine and implanted, and the patient is expected to urinate normally.

What Is The Recovery Process Like After Robotic Cystectomy Surgery?

The recovery process after robotic cystectomy varies depending on the type of cystectomy performed, the type of urinary diversion after the procedure, and the patient's overall health. Robotic cystectomy requires at least one night's hospital stay, while open surgery requires a longer stay. The patient and their family are informed about the use of external devices such as drains, catheters, and stomas. Strenuous physical activity and exercise should be avoided for 4-6 weeks after robotic cystectomy surgery, and particular attention should be paid to wound care and stoma hygiene to prevent infection.

Is Sexual Function Preserved After Robotic Cystectomy Surgery?

Preserving sexual function after robotic cystectomy depends on the use of nerve-sparing techniques during surgery. These techniques are crucial for preserving erectile function and vaginal integrity.

What Is The Nerve-Sparing Method In Robotic Cystectomy Surgery?

Nerve-sparing is a surgical dissection technique aimed at preserving autonomic nerve fibers associated with pelvic secretion, urinary control, and erection. In robotic cystectomy, the nerve-sparing method offers a higher success rate compared to open surgery.

What Is The Quality Of Life Like After Robotic Cystectomy Surgery?

Quality of life after robotic cystectomy surgery varies depending on the type of urinary diversion performed, the patient's postoperative condition, and complications. Patients who have a stoma require an adjustment period; orthotopic neobladder (artificial bladder) may be more comfortable but is not suitable for every patient. It may take weeks for patients to return to their normal lives.

Is There A Risk Of Cancer Recurrence After Robotic Cystectomy Surgery?

As with other types of cancer, there is a risk of bladder cancer recurrence after robotic cystectomy surgery. Patients should monitor their health status with regular screenings and follow-ups after cancer surgery.

How Much Does Robotic Cystectomy Surgery Cost?

The price of robotic cystectomy surgery varies depending on the patient's insurance status, the hospital, the doctor, the equipment used, the length of hospital stay, and the scope of the procedure.