Invasive Bladder Cancer - Non Cystectomy Treatments???

Carmine the 3 main diversions are explained very well here-Joe

pennhealth.com/ency/article/000486.htm

The DaVinci procedure for cystectomy is being used at some institutions...Mayo uses it and Johns Hopkins uses it and others are following suit. I guess the important thing to ask is How many have you done this way? Its becoming quite standard with prostatectomies. There is a lot of information on the main page here on the different diversions. Did your surgeon seem to have a preference? Pat

Carmine I had a link which said the Davinci surgery as far as diversions was still getting off the ground I know they can do the Ileal Conduit Bag but as far as the Indiana Pouch or Neobladder I believe these are more of a hands on procedure. There is alot more involved to reconstruct these 2 diversions and I have not found anywhere that they can do these two procedures the DaVinci way. My surgeon at Penn does the robotic prostrate but he never even offered me this for my bladder surgery here take a peek. And really this Davinci surgery right now seems more aimed at prostrate surgery to me.

pennhealth.com/Wagform/MainPage.aspx?config=provider&P=PP&ID=1398

I am going back the beginning of November for my first post op visit whoopie lol and I am going to ask a few questions about this. The reason and I am certain is that he could not do the Neobladder or Indiana Pouch this way. Well hands on or off I can't complain I ended up with the Indiana Pouch there was a problem when he opened me up for the Neobladder and as of now I am cancer free. but I'm certain one day here soon these robots will be doing most of the surgeries and all the older surgeons will be going back to school lol. Joe

Wendy,
I am not really clear on the exact details for each of those urine diversion procedures.(Indiana pouch, external, internal, neo)or DaVinci - vs - non DaVinci. If I go with the robotic surgery, do I still have the same choices for the diversion procedures or does it limit which I can choose? My Dr. wasn't very clear or I missed some of his explainations.
Appreciate all of your help.
- Carmine -

Hi Carmine,

Da Vinci is hands on...the newest info says that the best results are got by doing the bladder revision (making either a pouch, continent reservoir or neobladder) outside of the body rather than inside. The thing that is not yet clear regarding this procedure is the amount of lymph nodes removed during surgery. There is a school of thought that says the more nodes removed the better the long term outcome.

We have info about Da Vinci on WebCafe here:
blcwebcafe.org/roboticsurgery.asp

Carmine, I sent you a PM.

Zach