da Vinci Surgery
 

Bladder Cancer Treatment

(Muscle-invasive Bladder Cancer)

Muscle-invasive bladder cancer refers to cancer that has spread into the muscle wall of the bladder. The primary treatment for muscle-invasive bladder cancer ― or bladder cancer that has returned ― is removal of the bladder. This is known as a radical cystectomy.

Radical cystectomy is considered the gold standard treatment for this type of cancer, but it is a major operation that significantly changes a person’s life. 1

Besides removing the bladder, surgeons will also remove lymph nodes and nearby organs, if they contain cancer. In men, the nearby organs that may need to be removed are the prostate and seminal vesicles (glands that produce semen). In women, the uterus, ovaries and part of the vagina may need to be removed.

Following surgery to remove the bladder, your surgeon will create a new channel for urine to pass from your body. Options may include a neobladder – a new reservoir made of part of your intestine - or an ostomy bag connected to your urethra through an opening (stoma) in your stomach. Depending on approach used, the surgeon may still need to create a stoma. You may still also need to use a catheter to release the urine several times a day.2

Even if your doctor removes all of the cancer that can be seen during surgery, you may be also given chemotherapy to kill any cancer cells that might be left behind. In fact, research shows that chemotherapy before or after a radical cystectomy may improve survival for men with muscle-invasive bladder cancer.3

There are options when it comes to the type of surgery available to bladder cancer patients, including:

Open Surgery

Currently, the majority of bladder cancer operations are performed using traditional open surgery. In this approach, a large abdominal incision is made to manually access the bladder, surrounding tissues and organs. Open surgery is considered very invasive and traumatic on the body.

Laparoscopic Surgery

In this approach, the surgeon makes several small incisions, instead of the one large incision used in traditional open surgery. The surgeon uses long, narrow instruments to access and remove the bladder. This surgery may take longer, but recovery is typically less painful.1 Because of the limitations of the instruments and vision system, your doctor may not recommend laparoscopic surgery for operations considered to be delicate or complex.

da Vinci® Surgery

If your doctor recommends surgery to treat bladder cancer, you may be a candidate for a breakthrough, minimally invasive approach - da Vinci® Surgery. da Vinci Surgery uses state-of-the-art technology to help your doctor perform a more precise operation than conventional instrumentation allows. 

da Vinci Cystectomy incorporates the best techniques of open surgery – including comprehensive cancer control – and applies them to a robotic-assisted, minimally invasive approach. da Vinci Cystectomy offers patients several potential benefits over open surgery, including:

  • Significantly less pain4
  • Less blood loss4
  • Less risk of major complications5
  • Earlier return to bowel function4
  • Fast return to normal diet5
  • Less scarring compared to open surgery

da Vinci Surgery: Precision and Dexterity

For many patients, the precision and dexterity of the da Vinci Surgical System may mean their doctors can offer a minimally invasive bladder cancer surgery. If you are facing bladder cancer surgery, talk to a doctor who performs da Vinci Surgery. To find a da Vinci surgeon, use our surgeon locator.

As with any surgery, these benefits cannot be guaranteed since surgery is unique to each patient and procedure. All surgeries, including da Vinci Surgery, involve risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation.

  1. Stein JP, Lieskovsky G, Cote R et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 2001; 19: 666–75
  2. American Cancer Society. Detailed Guide: Bladder Cancer Surgery. http://www.acsevents.org/docroot/CRI/content/CRI_2_4_4X_Surgery_44.asp
  3. American Society of Clinical Oncology. Bladder Cancer - Treatment. Available from:. www.cancer.net/patient/Cancer+Types/Bladder+Cancer?sectionTitle=Treatment
  4. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Nguyen PL, Choueiri TK, Kibel AS, Hu JC. Comparative Analysis of Outcomes and Costs Following Open Radical Cystectomy Versus Robot-Assisted Laparoscopic Radical Cystectomy: Results From the US Nationwide Inpatient Sample. Eur Urol. 2012 Jun;61(6):1239-44. Epub 2012 Mar 30.
  5. Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS. Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS. Eur Urol. 2010 Feb;57(2):196-201. Epub 2009 Oct 20.
  6. Ng CK, Kauffman EC, Lee MM, Otto BJ, Portnoff A, Ehrlich JR, Schwartz MJ, Wang GJ, Scherr DS. A Comparison of Postoperative Complications in Open versus Robotic Cystectomy. Eur Urol(2009) doi: 10.1016/j.eururo.2009.06.001

While clinical studies support the effectiveness of the da Vinci Surgical System when used in minimally invasive surgery, individual results may vary. There are no guarantees of outcome. All surgeries involve the risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation. Surgery with the da Vinci Surgical System may not be appropriate for every individual; it may not be applicable to your condition. Always ask your doctor about all treatment options, as well as their risks and benefits. Only your doctor can determine whether da Vinci Surgery is appropriate for your situation. The clinical information and opinions, including any inaccuracies expressed in this material by patients or doctor about da Vinci Surgery are not necessarily those of Intuitive Surgical, Inc. and should not be considered as substitute for medical advice provided by your doctor. All people depicted unless otherwise noted are models.  © 2012 Intuitive Surgical. All rights reserved. Intuitive, Intuitive Surgical, da Vinci, da Vinci S, da Vinci Si, Single-Site,  InSite, TilePro and EndoWrist are trademarks or registered trademarks of Intuitive Surgical. All other product names are trademarks or registered trademarks of their respective holders.

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