Bladder Procedures
Laparoscopic Radical Cystectomy
Indication
Muscle-invasive bladder cancer (transitional cell carcinoma).
Bladder Cancer Overview
Bladder cancer accounts for approximately 90% of cancers of the urinary tract (renal pelvis, ureters, bladder, urethra). Incidence of bladder cancer increases with age. People over the age of 70 develop the disease 2 to 3 times more often than those aged 55–69 and 15 to 20 times more often than those aged 30–54.
Bladder cancer usually originates in the bladder lining, which consists of a mucous layer of surface cells that expand and deflate (transitional epithelial cells), smooth muscle, and a fibrous layer. Tumors are categorized as low-stage (superficial) or high-stage (muscle invasive). This is determined after microscopic examination after transurethral resection of the tumor (biopsy).
Treatment
Complete removal of the bladder, surrounding lymph nodes, and prostate (men) or uterus/ovaries if present (women). A new bladder is then reconstructed from small bowel (neobladder/Indiana pouch) or a conduit (ileal conduit) is formed to divert urine to an external appliance. This is a major operation requiring not only removal of an organ, but reconstruction as well.
Minimally Invasive Approach
Even though this is one of the most difficult and complex of all urological procedures, our department's experience and expertise allow us to use minimally invasive techniques as our primary approach.