Bladder cancer surgery is entering a new era. As recent as 15 years ago, the “gold standard” for surgical treatment of bladder cancer was an open radical cystectomy (a long and complicated procedure in which a patient’s bladder was removed). Few options were available for the patient, at all but less than a handful of comprehensive cancer centers around the country. Since the 90s, the advent of technology have allowed for the refinement of laparoscopic techniques for the surgical removal of the bladder. This was due in part to the success of robotic assistance in radical prostatectomy, which has since led to robotic approaches for radical cystectomy.

A radical cystectomy is the surgical removal of all or part of the bladder. It is used to treat bladder cancer that has spread into the bladder wall (stages II and III) or to treat cancer that has recurred following initial treatment. Unlike prostate cancer, which is very slow growing, bladder cancer can be one of the most aggressive and rapidly growing forms of cancer.

According to the National Cancer Institute, bladder cancer is the fourth most commonly diagnosed cancer in men and the eighth most common in women. Depending on the stage and location, bladder cancer is often treated by surgically removing the bladder in a procedure called a cystectomy. This procedure can also involve removal of the nearby lymph nodes and part of the urethra, as well as the prostate (in men) and the uterus, fallopian tubes, ovaries and part of the vagina (in women).

Traditional cystectomies are performed through an open procedure involving a large incision across the lower abdomen. These surgeries can damage surrounding tissues and nerves and commonly result in loss or reductions in sexual function, including impotence. Robot-assisted cystectomy can avoid or minimize many of the problems associated with the traditional procedure. This minimally invasive technique helps preserve the surrounding tissue and spare the nerves to promote a return to normal sexual function.

Under the direction of Lee Richstone, MD, Director of Laparoscopy and Robotic Surgery at the Smith Institute for Urology, the minimally invasive robotic technique offers patients access to nerve-sparing urologic and prostate surgical procedures that help maintain normal function. “Compared to traditional surgery, these minimally invasive procedures result in quicker recovery, less pain and less scarring,” said Dr. Richstone. “In addition, patients generally return to a normal diet sooner and spend less post-surgical time in the hospital than they would if their procedure was performed in the traditional open procedure.”

There are probably fewer than a dozen facilities in this country where skilled urological surgeons perform robotic cystectomies.

The five-year survival rate for bladder cancer is about 60 percent, depending on how deep the cancer has penetrated the bladder wall. Risk factors for bladder cancer according to the National Cancer Institute include: tobacco use, age, some parasitic infections and personal history of bladder cancer. White males are also at greater risk. Common symptoms include blood in the urine, pain during urination and frequent urination. The symptoms, however, are not sure signs of bladder cancer and could be symptoms of infections, benign tumors, bladder stones or other problems.

The Arthur Smith Institute of Urology is the only facility on Long Island, and one of two in the New York area to routinely perform this procedure using this technique.

Media Contact: Adina Conn (516) 465-2620