Surgery for Bladder Cancer

Minimally Invasive Approach

At Scott & White, the majority of cystectomies are performed with minimally invasive techniques. Benefits of minimally invasive surgery include:

  • Better cosmetic result
  • Quicker recovery times, allowing you to:
    • Return to your daily routine sooner
    • Begin future treatment sooner
  • Shorter hospital stay
  • Less pain
  • Less blood loss
  • Lower risk of infection
  • Fewer complications

Not all patients are candidates for a minimally invasive approach. Factors affecting the decision to use minimally invasive techniques include:

  • Tumor size or location
  • Patient obesity and health
  • Prior surgeries

 

Your Integrated Care Team may recommend the surgical removal of all or part of your bladder. Your team may recommend other treatments in addition to surgery. We use minimally invasive techniques whenever possible and indicated.

At Scott & White, treatment goals for bladder cancer generally are centered on bladder-preserving treatments. Our philosophy is to preserve as much of your bladder as reasonable while removing as much cancer as possible.

If you can do the same surgery with lesser invasive procedures that meets the standard of care of what the open surgery was, then I think it’s the preferred approach.

Lucas Jacomides, MD, Urology – Round Rock Clinic

Surgical Procedures

Your operation will be performed using one of the following methods:

  • A traditional open approach
  • Traditional laparoscopic surgery

Your physician will discuss which option is best for you.

Transurethral Resection of the Bladder (TURB)

In this bladder-sparing surgical procedure, your physician will remove your tumor and a small part of your bladder. Your surgeon will insert a special tool with a wire loop on the end through your urethra to remove the cancerous tissue from your bladder. This surgery saves significant bladder tissue.

Additionally, during this procedure, your surgeon may burn the base of the tumor in your bladder with a process called fulguration, which destroys any remaining parts of your tumor with electricity.

This procedure is generally recommended for patients with early-stage bladder cancer.

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Cystectomy/Bladder Removal

Partial Cystectomy

In this surgical procedure, your physician will remove your tumor and part of your bladder.

Total Cystectomy

In this surgical procedure, your physician will remove your tumor, your entire bladder and adjacent lymph nodes.

Bladder Reconstruction

After a total cystectomy, your surgeon will create an alternate means for urine to leave your body.  Your surgeon usually uses a segment of your small or large intestine.

At Scott & White, bladder reconstruction is performed in the following two ways:

  • Urostomy appliance bag — placed over a mouth-like opening (a stoma) that drains continuously
  • Continent urinary diversion — a continuously draining stoma that doesn’t require the use of a bag
    • Includes a thin tube (catheter) placed through the stoma
      • Indiana Pouch
      • Florida Pouch
      • Koch Pouch
    • Includes a neobladder — a reservoir usually created from your small intestine; it’s placed in the previous location of your bladder
      • Your neobladder is then connected to your ureters and urethra, allowing you to urinate or void in a fairly normal manner
      • At Scott & White, we generally use the “Studer” or “Hautmann” neobladder techniques

Your surgeon will discuss with you which option of bladder reconstruction is best for you.

A cystectomy may be accompanied by additional cancer treatments, such as radiation therapy or chemotherapy. Your physician will discuss which additional treatments, if any, are best for you.

As with all operations, there are some risks. Your surgeon will discuss these risks with you.

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