The Advantages of Robot-Assisted Surgery

If you ask most men about their health concerns, bladder cancer probably would not be on their list. Yet, according to the American Cancer Society, bladder cancer occurs three times more often in men than women and is the fourth most common cancer among men. Smoking is the biggest risk factor and causes about half of all cases.

Whether someone with bladder cancer is treated with chemotherapy, radiation or surgery depends on its stage and how deep the disease has penetrated into the bladder muscle.

“One of my recent patients, Brian Constable, had stage two, muscle-invasive bladder cancer,” says urologist Khanh Pham, MD, of Washington Urology. “The ‘gold standard’ treatment approach for this type is chemotherapy followed by surgical removal of the bladder.”

A cystectomy (bladder removal surgery) is typically an “open” surgery, but at Overlake it is performed robotically.

Robot-assisted surgery affords surgeons a broader field of vision and increased accuracy compared to traditional open surgery. The robot is under control of the surgeon at all times. Its precision translates to advantages for the patient, such as smaller incisions, less blood loss and less pain at incision sites.

Robotic surgery also requires less pain medication since the incisions are smaller. Pain medicine tends to cause the intestines to slow down. For cystectomies in particular, minimal pain medicine allows the bowel to more quickly return to normal function. The faster the recovery time, the sooner a patient can return to their usual life.

In addition to removing the bladder and lymph nodes during bladder cancer surgery, the prostate is removed because the lining inside the urethra of the prostate is the same cell type as the bladder. Removing these structures increases a patient’s long-term survival rate since the likelihood is higher that all the cancer was removed.

And, thankfully, for Brian, that was the case. “He had the best scenario in that there wasn’t any residual disease found in his bladder,” adds Dr. Pham.

To create a new way for urine to leave the body, a robotic cystectomy also involves urinary tract reconstruction. Dr. Pham teams up with fellow surgeon Elizabeth Miller, MD, who performs the reconstructive portion of these surgeries. There are three options for reconstruction, and Dr. Pham helps patients decide which approach will work best for their lifestyle. 

The most common symptom of bladder cancer is blood in the urine. See your healthcare provider as soon as possible if you experience this or other changes in your health.