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Radical cystectomy
is the gold standard treatment for muscle invasive bladder cancer. It involves removal
of the bladder, prostate, seminal vesicles and surrounding fat and attachments in
men, and in women, also the uterus, cervix, urethra and anterior vaginal wall. Radical
surgery for bladder cancer can be performed by open surgical techniques or by newer
advancements like Robotic surgery.
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Robotic radical cystectomy is the latest advancement in
technique of surgical removal of bladder and pelvic lymph nodes which achieves comparable
results while minimizing morbidity. In this technique, we use the da Vinci Robotic
surgical system which imitates the surgeon’s movement on the operating console into
fine actions inside the body. The precision of surgery results in sparing of vital
but delicate nerves and tissue which in turn facilitates a faster recovery, fewer
complications and a shorter hospital stay.
Some of the benefits of Robot Assisted Radical Cystectomy include: |
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- Minimal damage to vital nerves and tissue
- Significantly reduced morbidity
- Less blood loss
- Reduced risk of infection
- Less postoperative pain and discomfort
- Fewer noticeable scars
- Advantage of high- definition 3D visualization and
robot assisted suturing for better anastomosis
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Since, the bladder is removed; you will need an alternative
way of passing urine. This can be in the form of Ileal conduit or Neobladder
- Ileal Conduit-
Here the surgeon makes a small urine reservoir using a small segment of intestine.
One end of the segment of small intestine opens on to the skin of the abdomen. Urine
draining through this collects into a bag which the patient wears on the outside
of the abdomen.
- Continent diversion
and Neobladder – For continent cutaneous diversion, a pouch is constructed
out of portions of the small and large intestine; the ureters are connected to the
pouch and a stoma is created through the abdominal wall. Urine is removed intermittently
by the patient by inserting a thin tube (catheter) into the stoma. Alternatively,
a similar pouch using the intestine is created and attached to the urethra; in an
attempt to preserve the functions as close to normal bladder functions as possible.
Discuss with your doctor about the suitable urinary diversion
technique for you.
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