Robot-assisted surgery for muscle-invasive bladder cancer
Muscle-invasive bladder cancer is a serious form of bladder cancer that requires aggressive treatment. It involves a tumor that has penetrated the muscle layer of the bladder wall and carries a high risk of metastasis and recurrence. The use of robot-assisted surgery offers modern treatment options that are both effective and gentle for the patient.
In many cases, robot-assisted surgery enables the performance of a radical cystectomy, where the bladder is completely removed. In men, the bladder is removed along with the prostate, and in women with the uterus. These procedures are usually combined with extensive lymphadenectomy to ensure that all potentially affected lymph nodes are removed.
An important aspect of the surgical treatment of muscle-invasive bladder cancer is the type of urinary diversion after bladder removal. There are various methods of urinary diversion:
- Incontinent (wet) urinary diversion: Methods such as ureterocutaneostomy or ileum conduit. In the latter, urine is diverted through a piece of intestine that is brought to the surface of the body. Wearing a urine bag is necessary.
- Continent urinary diversion: The ileum neobladder, a form of urinary diversion where a new bladder is formed from a section of intestine, allowing more natural urine storage and elimination. This option is only suitable for physically fit patients, as it requires good physical condition and motivation for regular self-monitoring.
Robot-assisted surgery is a precise technique that offers advantages in such complex operations, including minimal invasiveness of the procedure, significantly less postoperative pain, and faster wound healing. These benefits lead to a shorter hospital stay and a quicker return to daily life.
Preparation for surgery includes thorough diagnostics, including imaging procedures and possibly preoperative chemotherapy, depending on the stage of the tumor. Admission usually takes place the day before surgery, and the procedure is performed under general anesthesia.
After surgery, patients are monitored in the intensive care unit and later moved to a regular ward once their vital functions stabilize. Postoperative care includes pain management, mobilization, and monitoring for possible complications. Discharge typically occurs within 2 weeks, depending on the patient’s recovery.
Postoperatively, it is important to avoid physical exertion for about eight weeks not to compromise the healing. Tumor follow-up is crucial and includes regular checks using laboratory tests and imaging.
