ROBOTIC CYSTECTOMY

Hi Star,

I have been following your posts and saying prayers for you as you navigate thru the bladder cancer. Just thought I would let you know I had cystectomy/neobladder done in March at Mayo's in Minnesota by Da Vinci. My surgery was 3.5 hours to do the removal, neo and take 35 lymphnodes. Another surgeon from the University of Wis Madison was offering to do it traditionally with on the table time of 7-9 hours. I did need 2 units of blood within 2 days of the surgery - I think that would have happened regaurdless tho. I was pleased with the robotic and I would highly recommend it. Best wishes and God bless, Holly

That's what I meant. For cystectomies it's not a real viable option unless you want to travel. My own opinion is that, as it is right now, I would choose the surgeon over method. I'd rather have Dr. Stein or Dr. Schoenberg operating on me conventionally than someone less experienced using a Da Vinci.

Your mileage, as always, may vary.

Don't misunderstand me--this is a thrilling technology. At the moment, for most of us, it's just a little too far around the corner.

Actually the DaVinci is in about 500 hospitals now ... only problem is they're using it for heart surgery, prostate surgery, and you name the surgery ..everything but cystectomy. However, having said that there are a few major centers that are using it for cystectomy...Mayo Clinic for one..and Mt. Sinai.......I'll have to do a little research to find out the others if any. Its still a learning curve and the young docs coming up who were weaned on video games are whizes at mastering this system. In my major city where there is noone doing Indiana Pouches and maybe there is one neo-bladder floating around...it's not going to happen anytime soon...but they are using it for bypass surgery at one of the major hospitals..interestingly enough not the major heart hospital here. Pat

Reading it makes me wish I was diagnosed a few years down the line when it's a more common and accepted procedure.

Unfortunately for now, it's only used in a very few hospitals, and those who need a cystectomy don't have the luxury of waiting.

Something better is always around the corner. And for those yet-to-be-diagnosed folk who are going to benefit from a laparoscopic cystectomy, it's terrific. I think this is a huge step forward in surgical procedures. If I had a choice of conventional surgery or Da Vince surgery, all things being equal, I'd certainly opt for the laparoscopic route. But for those who need surgery now or in the near future, it's not really a viable option.

OKAY WHAT ARE THE THOUGHT ABOUT THIS FOLKS.???????

DAVID SAMADI HEAD AT MOUNT SANAI
Robotic surgical systems have thrust minimally invasive surgical options into a new era. For years now, surgeons and urologic oncologists have relied on the minimally invasive nature and nerve-sparing virtues of the procedure known as laparoscopic cystectomy to offer their patients the most effective treatment for bladder cancer. Not so long ago at all, cystectomy was performed using a traditional open surgical procedure; and therefore usually involved notable tissue and nerve damage, significant blood loss and carried a greater risk of post-operative infections and complications. By comparison, the robotic-assisted laparoscopic cystectomy, (also known as Da Vinci Robotic Cystectomy) may seem a bit like a kind of state-of-the-art miracle.


In reality, the robotic cystectomy is simply a newer and more effectual minimally invasive bladder cancer surgical method. It that makes use of the Da Vinci Robotic Surgical System and imitates a surgeon’s movements—and amplify their precision, and in so doing, it offers bladder cancer patients the prospect of a more effective surgical and less problematic post-surgical outcome. It is fast becoming the favored surgical answer to cancer of the bladder. A minimally invasive surgical procedure will allow your surgeon, oncologist or urologist to operate without making large incisions; the result spares vital but delicate nerve and muscle tissue and facilitates a faster recovery time, fewer complications and a shorter hospital stay.

Just as with a standard laparoscopic cystectomy, the robotic-assisted version of cystectomy may call for urinary diversion followed by reconstruction once a bladder has been removed.

For men and women alike, such reconstruction would include a continent reservoir to hold urine within the abdomen until a patient has been fitted with a either a catheter—to empty urine or a bladder replacement and an ileal conduit—a urinary diversion that will collect urine in an external bag. More importantly, using the Da Vinci Robotic Surgical System will provide your physician with a superior visualization plane and more surgical dexterity during bladder removal, as well as during any necessary reconstructive procedure.

By offering your surgeon, urologist or oncologist a high-definition 3-D view, the Da Vinci Surgical Robot allows the vital muscles and delicate nerve tissues, surrounding the operative area to be more easily identified – and spared. The Robot’s unique EndoWrist Instruments offer physicians surgical dexterity that is simply not available to them when they’re using conventional laparoscopic instruments. By taking advantage of the Da Vinci Robot, surgeons are able to surgically dissect and reconstruct the bladder with relative ease.

SUMMARY OF ROBOTIC-ASSISTED CYSTECTOMY:


The advantages of a procedure designed to spare delicate nerve and muscle tissue.
Keyhole sized incisions distributed across you abdomen.
A brief 4 to 7 day hospital stay.
Less risk of blood loss …and a lower chance that you’ll need a blood transfusion.
Reduced scarring, minimal discomfort and less need for major pain medication.
Only one to three months’ worth of recovery time before you’ll regain your normal level of urine control.
*The benefits of da Vinci Robotic Prostatectomy cannot be guaranteed as surgery is both patient and procedure specific.

BENEFITS OF ROBOTIC-ASSISTED CYSTECTOMY:


Minimal damage to vital muscle and delicate nerve tissue as a result of the surgery.
A shorter hospital stay and an even faster return to your normal level of activity.
Fewer noticeable scars.
Minimized risk of blood loss.
Minimized chances of post-operative infections.
Minimized chances of post-operative incontinence or impotence.
Minimized chances of other complications commonly associated with cystectomy.
Minimal post-operative pain and discomfort
You’ll have the unprecedented capacity of the Da Vinci Robotic Surgical System to offer surgeons, oncologists and urologists a high-definition, three-dimensional view of the procedure as well as robotically assisted suturing and stitching, at your disposal.
TYPICAL OPEN SURGICAL CYSTECTOMY:

Greater risks associated with any procedure that requires a larger surgical cut-in
Potentially greater discomfort and a longer post-operative hospital stay
Potenntially more postoperative scarring, muscle damage and nerve damage
Potentially more postoperative soreness and a greater need for perscription pain medication
Longer post operative recovery time
Before you decide on which course of action would be right for you, it may help you to know that open surgery patients can experience five times the loss of blood, have four times the risk of other complications, a high chance of infection, incontinence or impotence and are forced to spend roughly three times as much time in the hospital as patients who opt for robotic-assisted surgery.

Robotic-Assisted cystectomy also offers patients a cancer removal rate that’s 14% higher … as well as increased prospects that they’ll be able to engage in normal sexual activity in as little as 11 months — by comparison, patients who opt for open surgery are often unable to for years.