Robotic Cystectomy for Bladder Cancer
Bladder cancer accounts for 3% of all malignancies and is one of the most common tumors in Urology.
It is treated with different therapeutic options depending on the stage of the disease (superficial or invasive). In most cases, treatment is surgical, but depending on the type of cancer, it may also be combined with other therapies such as radiation therapy, chemotherapy, or intravesical hyperthermic chemotherapy HIVEC.
If surgical removal of the bladder is necessary, always depending on the needs of each patient, a partial cystectomy may be performed, with or without ureteral reimplantation, or a radical cystectomy with the creation of an orthotopic continent neobladder.
Radical Cystectomy is the main treatment for bladder cancer when there is clear evidence that the cancer has invaded the muscular wall of the bladder (muscle-invasive). It includes the simultaneous creation of an orthotopic continent neobladder, so that urine can be stored and discharged from the body. In cases where this is not feasible, urinary diversion to the abdominal wall is performed and the urine is collected in a special bag.
Until recently, radical cystectomy was performed using conventional open surgery, through a large incision in the abdominal area. Although laparoscopic surgery is minimally invasive, it limits the surgeon’s full control of the operative field compared with open surgery.
Robotic Radical Cystectomy
Robotic radical cystectomy represents a revolution in bladder surgery, offering an oncological outcome equivalent to that of open surgery, while providing very significant benefits for the patient.
The procedure is performed in the operating room using the DA VINCI robotic system under general anesthesia. It includes removal of the entire urinary bladder, as well as adjacent lymph nodes or organs that have been infiltrated by cancer. Such organs include the prostate and seminal vesicles.
This is followed by the creation of a new bladder using a segment of intestine, allowing the patient to urinate normally, or, in cases where this is not feasible, urinary diversion to the abdominal wall is performed and the urine is collected in a special bag.
Robotic radical cystectomy is a highly demanding procedure that requires excellent robotic surgical technique. The oncological outcomes are excellent.
The advantages of robotic radical cystectomy are:
- Surgery through very small incisions,
- 10- to 15-fold image magnification and improved lighting for an optimal visual field for the Urological Surgeon,
- Short hospital stay (4-5 days),
- Minimal pain,
- Reduced risk of infection,
- Minimal blood loss and no need for transfusion,
- Rapid recovery after surgery,
- Rapid return to normal activity,
- Minimal postoperative wound-related complications, such as suppuration, wound dehiscence, hernia, chronic pain, unsightly scarring, etc.
- Significantly lower cardiovascular and respiratory burden.
- Possibility of treating patients with a complicated medical history.
Interbalkan Medical Center of Thessaloniki was the first in Thessaloniki and Northern Greece to install the DA VINCI Robotic System, providing Urological Surgeons certified in robotic techniques with the opportunity to now possess the greatest experience in radical or partial nephrectomy for kidney tumors.
