What is a Cystectomy? A cystectomy is a surgical procedure for bladder removal, commonly performed to treat muscle-invasive bladder cancer or when other treatments fail.

Why Choose Robotic Surgery for Cystectomy? Robotic cystectomy is a minimally invasive surgical technique that offers enhanced precision, flexibility, and control. Compared to traditional open surgery, robotic-assisted cystectomy provides benefits such as smaller incisions, less postoperative pain, reduced blood loss, shorter hospital stays, and quicker recovery times.

Types of Urinary Diversion After Robotic Cystectomy Following bladder removal, creating a new urinary pathway is essential. Two common urinary diversion methods are the ileal conduit and the neobladder.

Robotic Cystectomy with Ileal Conduit

Procedure Overview:

• Bladder Removal: The urinary bladder is removed using advanced robotic-assisted techniques.
• Creating the Ileal Conduit: A short segment of the small intestine (ileum) is repurposed to form a conduit. This conduit connects the ureters (which carry urine from the kidneys) to a stoma, an opening in the abdominal wall where urine exits into an external bag.

Post-Surgery Care:

• Stoma Care: Learning proper stoma care is crucial as it serves as the exit point for urine.
• Managing the External Bag: The external urine collection bag attached to the stoma needs regular emptying and changing.
• Lifestyle Adjustments: While living with an ileal conduit requires some lifestyle changes, most patients adapt well and return to regular activities.

Robotic Cystectomy with Neobladder

Procedure Overview:

• Bladder Removal: The bladder is removed using robotic-assisted techniques.
• Creating the Neobladder: A larger segment of the small intestine is reshaped into a neobladder, which connects to the ureters and urethra. This allows urine to pass naturally through the urethra.

Post-Surgery Care:

• Urinary Function: Initially, you may need to relearn urination techniques, as the neobladder lacks the nerve supply of a natural bladder. Temporary use of a catheter may be required to ensure complete emptying.
• Incontinence Management: Some patients may experience urinary incontinence, particularly at night, but this often improves over time.
• Lifestyle Adjustments: It’s important to monitor for urinary retention or infection and follow guidelines to maintain neobladder health.

Recovery and Follow-Up

Hospital Stay: Most patients require a hospital stay of 5-7 days post-surgery.

Pain Management: Postoperative pain is usually manageable with oral medications, with robotic surgery often resulting in less pain compared to open surgery.

Physical Activity: Early mobilization is encouraged to aid healing and prevent complications like blood clots. Avoid heavy lifting and strenuous activities until cleared by your healthcare provider.

Diet and Hydration: Following a specific diet and maintaining proper hydration are crucial for recovery and preventing complications.

Monitoring: Regular follow-up appointments are essential for monitoring recovery, kidney function, and managing any potential complications.

Long-Term Considerations

Stoma Care (Ileal Conduit): Proper stoma care is vital for preventing skin irritation and infection around the stoma.

Neobladder Function (Neobladder): Learning to empty your new bladder completely, possibly using a catheter, is important. Regular follow-ups ensure the neobladder functions properly and monitor for any complications.

Lifestyle: Most patients can return to normal activities, including work and exercise, with some adjustments.

Conclusion Robotic cystectomy with either an ileal conduit or neobladder offers a minimally invasive, advanced surgical option for bladder cancer treatment. Understanding the procedure, recovery, and long-term care requirements will help you prepare for the surgery and manage your new urinary system effectively. Always consult your healthcare provider for personalized advice and detailed information.