The advent of robotic surgical systems has ushered in a new era of minimally invasive surgical options. One area in which robotic surgery has proven to be particularly useful is in the treatment of bladder cancer. Surgeons and urologic oncologists have been using robotic surgery to perform cystectomies that were formerly performed using open surgical procedures. The cystectomies performed using the older techniques would often result in severe complications like significant blood loss and post-operative infection. The risk of these complications occurring has today been minimized by the use of robotic cystectomies.
Simply put, a robotic cystectomy is a surgical procedure that is minimally invasive and more effective for the treatment of bladder cancer. The procedure is undertaken using the "da Vinci Surgical System" that uses a robotic arm to perform the procedure. The robotic arm can mimic a surgeon’s hand movements with much greater precision. A surgeon guides the robotic arms with the foot pedals and controllers. This precision translates into smaller incisions, less collateral damage to neighboring tissue and quicker recovery while minimizing the risk of complications. For this reason it has become the preferred technique for bladder cancer surgery.
The procedure is similar to a standard laparoscopic cystectomy. In addition, it may require a urinary diversion and reconstruction for the removed bladder. The reconstruction involves the making of a temporary continence reservoir to hold urine in the abdominal cavity and can later be removed once the patient is fitted with a catheter and a urine bag.
The robotic system allows for a high-definition, three dimensional view of the abdominal cavity. This allows the robotic system to spare the delicate nerve and muscle tissue that surrounds the operating area, leading to fewer post-surgical complications.
In addition to this benefit, the robotic system offers the surgeon a dexterity that would not be possible using standard laparoscopic techniques. This allows the surgeon to undertake the dissection and reconstruction of the bladder with an ease that is otherwise not possible.
To sum up, the benefits of robotic cystectomy are:
These benefits should be weighed against the risks associated with an open surgical cystectomy. They include:
Statistics show that open surgery for bladder cancer patients can result in 5 times the blood loss, 4 times the risk of impotence and infection and a longer hospital stay than robotic surgery. In addition to this, robotic surgery increases the chances of a resumption of sexual activities within eleven months of the surgery. However, the cost of a robotic cystectomy is steep may be beyond the budget of an average person.
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