New approach to robot-assisted bladder replacement may shorten recovery for bladder cancer patientsHouston, TX - 10/11/2012
For patients with aggressive bladder cancer, the best treatment remains the removal of the entire bladder and nearby lymph nodes, a procedure called radical cystectomy and lymphadenectomy. The procedure is complex, and often involves long post-surgery hospital stays and recovery time.
To help patients maintain urinary function, surgeons may have one or two options. The first, a neobladder, is the creation of a bladder substitute from a portion of the patient's small bowel. Another option, an ileal conduit, diverts urine directly out of the body to an external collection vessel.
Surgeons at The Methodist Hospital in Houston and a few other institutions around the country are looking at how robots may be used to make the surgery less invasive and less traumatic, which could translate into faster recovery times and better outcomes.
Alvin C. Goh, M.D., a urologic surgeon at The Methodist Hospital and Director of the Advanced Laparoscopic and Robotic Surgery Programs at The Methodist Institute for Technology, Innovation, and Education (MITIE), was part of a group that recently developed a neobladder reconstruction technique that is performed entirely inside the body and without large incisions -- with robotic assistance.
Goh recently presented data from a study of 24 patients eligible for this novel robotic reconstruction at the European Association of Urology special meeting on robotic surgery in London late last month. The methods described in the presentation were developed by Goh and his former colleagues at the University of Southern California and will be published in the November issue of European Urology.
Three month follow-up data were analyzed for 8 patients who received a neobladder and 7 patients who underwent an ileal conduit diversion.
The 8 patients who received neobladders were released from the hospital in about 8 days (median), and were able to eat normally about 5 days following the procedure. Overall, patients with an ileal conduit required 1 additional day in the hospital and to resume regular food intake. Eighty-seven percent of the patients had minor or no complications within 90 days following surgery.
"Early data on robotic radical cystectomy suggest decreased blood loss, lower pain medication requirements, and quicker recovery," Goh said. "Radical cystectomy with urinary reconstruction has traditionally been a maximally invasive undertaking. In our study, we have developed a truly minimally invasive approach. While our outcomes are promising, further investigation is needed to fully understand the benefits of this approach for our patients."
A video illustrating the new surgical technique won top prize at the European Association of Urology meeting.
There are about 74,000 new cases of bladder cancer in the U.S. each year.
To speak with Dr. Goh, please contact David Bricker, The Methodist Hospital System, at 832-667-5811 or firstname.lastname@example.org.