Laparoscopic Radical Cystectomy cost in India

Know More About Procedure & Surgery

What is Radical Cystectomy?

Radical cystectomy is a surgical procedure used to treat muscle-invasive bladder cancer without evidence of metastasis or with low-volume, resectable, loco regional metastases. In men, removing the entire bladder (radical cystectomy) typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy also involves removal of the uterus, ovaries and part of the vagina. After having your bladder removed, your surgeon also needs to create a urinary diversion — a new way to store urine and have it leave your body. There are multiple ways that urine can be stored and eliminated after bladder removal. Your doctor can help you decide which method is best for you.

Symptoms

Gross or microscopic hematuria is the initial presenting sign in 80-90% of patients with bladder cancer. Approximately 20% of patients have irritative symptoms such as urinary urgency, dysuria, or frequency.

Why it is needs to be done?

• Cancer that begins in the bladder or that begins nearby and grows to involve the bladder
• Birth defects that affect the urinary system
• Neurological or inflammatory disorders that affect the urinary system

Risks

Cystectomy carries with it certain risks, including:

• Bleeding
• Blood clots
• Heart attack
• Infection
• Pneumonia
• Rarely, death can happen after surgery

Since cystectomy is a surgery not just to remove the bladder but also to create a urinary diversion, the surgery includes additional risks, such as:

• Dehydration
• Electrolyte abnormalities
• Urinary tract infection
• A blockage that keeps food or liquid from passing through your intestines (bowel obstruction)
• A blockage in one of the tubes that carries urine from the kidneys (ureter blockage)

Preparation for Procedure

• You may need to make changes to your medications or avoid certain substances to help with healing and recovery after surgery.
• If you smoke, the best thing you can do for your health is to quit before surgery. Not only is smoking a risk factor for developing bladder cancer, smoking also increases the risk of developing problems after surgery.

During Procedure

In men, the prostate, seminal vesicles, and surrounding lymph nodes are removed. Men will not ejaculate after surgery. Although the ability to have an orgasm is not affected, many men may not be able to have a penile erection. It may be possible to spare the nerves controlling penile erection in some men. In these cases, restoration of potency usually occurs within one year of surgery. Alternative methods of achieving an erection can be used and should be discussed with your surgeon.

In women, often the ovaries, fallopian tube, uterus, cervix, part of the vagina, and surrounding lymph nodes are removed. Women who have their cervix or part of their vagina removed may have difficulty with sexual intercourse during the first few months after surgery. After several months, the tissue in the vagina may relax and lengthen, making sexual intercourse possible.

We personalize treatment plans to each individual patient. Some patients are best treated with an open operation. Many patients can now be treated using a robotic-assisted laparoscopic operation. In the open operation, an incision is made in the abdomen from the navel to the pubic bone. In the robotic-assisted laparoscopic operation, 6 small incisions (cuts) are created to insert the laparoscopic ports during the cystectomy portion of the surgery. A small incision is made in the abdomen to remove the bladder and lymph nodes as well as to create the urinary diversion, although this is done robotic-assisted laparoscopically in selected patients. Advantages of the robotic-assisted laparoscopic surgery can be decreased blood loss, earlier return of bowel function, shorter hospital stays, and earlier return to full activities.

After the Procedure

Depending on the specifics of your surgery, you may have a tube placed into your nose to decompress the stomach. You will be able to start drinking liquids when your intestines begin to recover. Intravenous fluids will provide nutrition in the meantime. Drinking and eating too soon may lead to nausea or vomiting. You will also not have a bowel movement for several days after surgery until the intestines recover. It is important to sit up and walk starting as early as the day after surgery. This will help prevent serious complications such as pneumonia and blood clots to form in the legs. Nurses and physical therapists will assist you as needed.

When you go home, most patients will be prescribed medication for pain and medication to prevent constipation, a common side effect from pain medication. Some patients may be given antibiotics. Take these as directed. It takes about 5 working days for the pathology to return. Generally you will still be in the hospital. Based on the pathology, we may discuss with you future treatments that may be necessary. Your first doctor visit after your surgery is usually scheduled for 2 to 3 weeks after you leave the hospital.