Robotic Cystectomy

A robotic cystectomy is a minimally invasive surgical procedure to remove the urinary bladder (cystectomy) using a surgical robot, most commonly the da Vinci Surgical System. It’s often performed for patients with muscle-invasive bladder cancer or some high-risk non–muscle invasive cancers that haven’t responded to other treatments.

Key Points about Robotic Cystectomy:

Indications

• Muscle-invasive bladder cancer
• High-risk or recurrent non–muscle invasive bladder cancer
• Occasionally for benign but severe bladder dysfunction (rare)

Procedure

• Small incisions are made in the abdomen.
• Robotic instruments and a camera are inserted.
• The bladder (and in men, often the prostate; in women, often the uterus, ovaries, and part of the vagina) is removed.
• Lymph nodes in the pelvis are also usually removed (pelvic lymph node dissection).
• A urinary diversion is then created so urine can leave the body:

1. Ileal conduit (urostomy bag)
2. Neobladder (new bladder made from intestine)
3. Continent cutaneous reservoir

Advantages over Open Surgery

• Smaller incisions → less pain and blood loss
• Shorter hospital stay and quicker recovery
• Better visualization with 3D magnification
• Precision in dissection and suturing

Risks & Complications

• Bleeding, infection, blood clots
• Urinary leakage or blockage
• Bowel obstruction (due to intestinal use in diversion)
• Erectile dysfunction in men, sexual dysfunction in women
• Long-term complications related to the urinary diversion

Recovery

• Hospital stay: 5–10 days
• Full recovery: 6–12 weeks
• Lifelong follow-up is required (cancer surveillance, diversion care)