Robotic cystectomies are minimally invasive procedures used to treat bladder illnesses that call for partial or complete bladder removal. When the cancer of the urinary bladder has advanced to the muscle wall, a radical cystectomy is performed. Compared to open cystectomy, when a sizable incision aids in the removal of the entire bladder, smaller incisions are made.
One of the most recent developments in the treatment of cancer is robotic surgery. Robotic cystectomy offers more flexibility than conventional laparoscopic procedures and benefits from the robot’s arms. With more flexibility, the surgeon is able to painstakingly do difficult procedures like internal stitching in the shape of a neobladder or urinary diversion. The robotic platform also offers the surgeon a 3D, high-definition picture of the abdomen’s inside. Precision is aided by this improved vision.
When Would a Robotic Cystectomy Be Necessary?
When cancer only affects a portion of the bladder or the patient has noncancerous bladder conditions, a robotic partial cystectomy is advised. However, a radical cystectomy is necessary in severe situations. Robotic surgery allows for less intrusion and quicker recovery. As a result, it can be done with caution in people with diabetes and other medical disorders.
Who makes a good candidate for a robotic cystectomy?
Patients with: are candidates for robotic cystectomy.
- A portion of the urinary bladder that has been invaded by bladder cancer
- Bladder involvement in pelvic malignancies such as colon and endometrial
- Bladder developmental anomalies requiring a straightforward cystectomy
- Fistula needing a partial cystectomy between the vagina, colon, and bladder
- Bladder diverticula can need a partial cystectomy or a diverticulectomy.
- Bladder schwannoma, pheochromocytoma, cavernous hemangioma, or localized endometriosis requiring partial cystectomy
Who should not think about having a robotic cystectomy?
The following conditions are not candidates for robotic cystectomy:
- The existence of intra-abdominal adhesions that are dense
- Pneumoperitoneum intolerance in patients
- Unable-to-assume Steep Trendelenburg (ST) position patients
- Heart disease, old age, poor pulmonary mechanics, and bleeding problems are examples of medical comorbidities.
- Metastatic illness evidence or advanced cancer stages
What does place during a robotic cystectomy?
A robotic cystectomy can be carried out while the patient is unconscious. Through the robotic console, the surgeon directs the robotic arms to operate the surgical equipment. The operating surgeon creates small cuts or incisions throughout the belly once anesthesia is in place in order to allow room for the robotic laparoscope to access the surgical site. A small camera and the surgical tools needed to complete the procedure are carried by the laparoscopic probe. The abdomen is expanded upon entry, and everything inside is displayed on televisions.
The surgeon removes malignant tissues from the lymph nodes, bladder, and any nearby questionable sites using robotic tools. Depending on the circumstances, the surgeon may choose to perform a urinary tract reconstruction in an open setting or with robotic assistance.
Extreme precision is made possible with the robot, which also greatly lessens postoperative pain for patients.
Risks and side effects following robotic cytoreduction
Although robotic cystectomy is a minimally invasive operation, it has its own set of dangers and issues, such as:
- Infection with Bleeding
- Clots of blood
- Neighbouring Organ injury
- Symptoms of anesthesia
After surgery, patients could also notice changes in how they pass the urine. The patient can experience frequent urination because the partial cystectomy causes the bladder to shrink. Additionally, some patients may experience sexual side effects include difficulty keeping an erection (erectile dysfunction) or discomfort during coitus. This occurs because the seminal vesicles and prostate may need to be removed during the procedure; as a result, these guys may never generate semen.In women, sexual activity is possible but could be uncomfortable if the vagina is partially removed. This is due to the possibility of nerve damage, which results in arousal and orgasm.
