Robotic Radical Cystectomy for Men and Women in NYC
Radical cystectomy is a major surgical procedure performed by urologists for patients with bladder cancer. Typically radical cystectomy is performed for patients with stage T2 and greater bladder cancer. Some patient’s with high-grade T1 and CIS of the bladder also require radical cystectomy. Radical cystectomy is a gold standard for treating muscle invasive bladder cancer.
[col type=”half last”]Radical cystectomy in male patients involves removal of the bladder along with the prostate. At urinary diversion is then required to collect and dispose of urine. Urinary divergent can be performed using ileal conduit or neobladder. Both neobladder and ileal conduit are created using bowel. A major difference between neobladder and ileal conduit is that ileal conduit is attached to a bag on the abdominal wall in which the urine is collected. The urine in the bag is then emptied. Neobladder is positioned in the pelvis inside the patient and connected to the urethra. The patient then empties the bladder as he or she would normally urinate.
Radical cystectomy in the female patient usually involves removal of the bladder, uterus, ovaries and part of the vaginal wall.
Neobladder is associated with higher rate of complications both short term and long term. Therefore careful selection of patients is necessary. Patients with renal insufficiency or tumor involving the urethra who are at high risk for urethral recurrence are not good candidates for neobladder.
Radical cystectomy can be performed through traditional open incision or using laparoscopic techniques with the da Vinci robotic system. Advantage of using robotic system for robotic radical cystectomy is lower blood loss.
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For patients who cannot undergo surgery or choose not to have surgery for aggressive muscle invasive bladder cancer, chemotherapy with radiation to the bladder is a viable treatment option.