This technique is performed as a curative procedure for muscle invasive bladder cancer or recurrent high grade superficial disease of the bladder. It involves removal of the bladder and appropriate surrounding organs as well as removing appropriate lymph nodes for cancer staging and possible therapeutic advantages. As the bladder helps store the urine, there are several techniques available to create a new urinary storage unit. This exact technique will involve discussion and planning between the patient, their family and their urologic surgeon during the pre-operative visits and counseling. Dr. Weeks is the first surgeon in the state of Washington to have robotically performed this surgery with excellent results.
This davinci radical cystectomy is set up similar to the davinci prostatectomy except that we add an extra port (1 cm incision) to the right lower abdomen. Through this technique, we are able to dissect the ureters, the bladder, the prostate if performed in a male, the uterus if present in the female, lymph nodes as well as protect the nerves for erectile function and the muscle for urinary control if needed. Either through a small incision or possibly with the robotic technique, we are able to create the urinary diversion that is appropriate for the patient’s specific case. The bladder, lymph nodes and appropriate other tissue will be removed through a small incision in the abdomen, depending on the technique used.
The benefits of the robotic technique are similar to all other minimally invasive procedures, including faster recovery, less blood loss, better visualization, less pain and a shorter hospital stay when compared to the open surgery technique.
Typically, the patient will spend 3-5 days with us in the hospital following the surgery, primarily teaching the patient how to care for their new urinary storage unit and waiting for the return of bowel function. The first night is usually in the ICU only for close observation and then transferred to the standard surgical recovery floor. Once here, we will encourage you to walk, start you on clear liquids and monitor your overall progress. Even after the patient is discharged home, there will be close follow up with Dr. Weeks in order to ensure proper recovery and patient comfort.