by Dr. C.H. Weaver M.D. (07/2018)
Robotic-assisted surgery for invasive bladder cancer is effective and results in less bleeding and shorter hospital stays when compared to the traditional open procedure, according to the results of a study published in the Journal of Urology.
The bladder is a hollow organ located in the pelvis. Its primary function is to store urine. The bladder has a muscular wall that allows it to get larger and smaller as urine is stored or emptied. Bladder cancer is diagnosed in roughly 50,000 men and 17,000 women annually in the United States.
Patients with bladder cancer may be treated with a radical cystectomy, which is the surgical removal of the bladder and some nearby organs. This procedure—called an open radical cystectomy—has proven effective for treating muscle-invasive bladder cancer; however, it is also associated with substantial complications—including blood loss and long hospital stays. Over the past decade, minimally invasive surgical procedures have become an alternative to several types of open surgery. Robotic-assisted radical cystectomy (RARC) is a type of laparoscopic procedure that allows for removal of the cancer without the invasiveness of an open procedure.
Researchers randomized 47 patients with invasive bladder cancer to undergo open radical cystectomy or RARC and then compared the outcomes of the two procedures. They found that patients in the RARC group had 50 percent less blood loss than patients in the open-surgery group and also had a lower rate of transfusions—40 percent compared to 50 percent in the open-surgery group. What’s more, patients in the RARC group were significantly more likely to leave the hospital within five days—35 percent of RARC patients left the hospital within five days, compared with 10 percent of open-surgery patients. The two groups did not differ significantly in oncologic outcomes.
The researchers concluded that RARC for invasive bladder cancer resulted in less bleeding and allowed patients to return home sooner—with no difference in oncologic outcomes compared with open surgery.
Parekh DJ, Messer J, Fitzgerald J, et al. Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. Journal of Urology. 2013; 189(2): 474-479.