Bladder cancer, the second most common urologic cancer after prostate cancer, usually develops in a highly treatable, but recurring form. In a smaller group of patients bladder cancer is much more aggressive and likely to spread through the layers of the bladder wall to other organs. Doctors in Columbia University's Department of Urology at NewYork-Presbyterian Hospital strive to preserve as much of the bladder for as long as possible in patients with invasive bladder cancer.
Robotic Procedures for Bladder Cancer
Some patients with more aggressive bladder cancer will eventually need a partial or radical cystectomy (surgery to remove part or all of the bladder). During a radical cystectomy surgeons remove the bladder and adjacent lymph nodes, part of the urethra, and nearby organs that may contain cancer cells. In men they may also remove the prostate, seminal vesicles, and part of the vas deferens. In women they may remove the cervix, uterus, ovaries, fallopian tubes, and part of the vagina.
The surgical team at Columbia Urology has the expertise to perform this extensive and complicated procedure in a minimally invasive manner, through several tiny holes in the abdomen, using a surgical robotic system. Our surgical team performs radical cystectomy using the da Vinci robotic surgery system, which gives surgeons a highly magnified view of the surgical field, and unsurpassed surgical dexterity and control of the miniaturized surgical instruments. Surgeons at Columbia Urology have more experience performing minimally invasive robotic cystectomy procedures than any other urologic surgery team in the world.
As with other minimally invasive procedures, patients benefit with shorter hospital stays, less pain, less blood loss, smaller incisions, and a quicker return to normal activities.
Reconstructive Robotic Surgery After Bladder Cancer
Patients who undergo radical cystectomy need a new way to store and eliminate urine. Members of our surgical team are pioneers in bladder reconstruction techniques following radical cystectomy. We can create a new bladder (neobladder) from a portion of the small intestine and attach it to the urethra, enabling both men and women to urinate in a more normal manner after bladder removal. Our complication rates for neobladder are among the lowest reported, and patients have even fewer complications following minimally invasive robotic cystectomy.
If a patient's urethra is damaged or diseased and we cannot use it to create a neobladder, surgeons here will create an internal bag called a continent reservoir that is connected to an opening in the abdomen. Patients can drain this bag several times a day using a catheter.
In deciding which type of reconstruction is best for each patient, we work closely with patients to determine their preferences and the status of their cancer at the time of robotic cystectomy. We tailor the operation to best suit each patient, while maintaining high cancer cure rates.