Tests and treatments
What is it?
A cystectomy is the surgical removal of the bladder. This procedure is most often performed to remove bladder cancer. The objective is to completely remove this aggressive cancer. For this reason, the prostate usually has to be removed along with the bladder. For women, the uterus almost always has to be removed along with the bladder. Both of these organs are more often than not stuck to each other because of the bladder cancer. For this reason, the surrounding lymph nodes are also usually removed, for men and women both. This is done because they could be affected by metastases of the bladder cancer. And so it is best to remove these lymph nodes during the same operation.
When the bladder is removed, a new channel is made for the urine.
Course of the procedure
A classic cystectomy is performed as an open operation, which means that the surgeon makes a large incision on the abdomen so as to be able to remove bladder.
It is possible to perform a cystectomy as a 'minimally-invasive' surgery. In a minimally-invasive surgery, long, thin instruments are used and very small incisions are made in the skin to remove the bladder and to create a new channel for the urine. It is essentially the same operation: the bladder and the surrounding organs and lymph nodes are removed.
The robot-assisted version of this procedure takes longer to perform than the classic approach. The robot-assisted procedure is characterised by less blood loss and by a shorter hospitalisation (1.5 days shorter). Some (not all) serious complications arise less frequently after a robot-assisted cystectomy.
It is thought that the robot-assisted procedure is successful in completely removing all types of bladder cancer. What is not clear yet is if this holds for more aggressive types of cancer. Scientific research is still ongoing.
Centres and specialist areas
Latest publication date: 05/02/2021
Supervising author: Dr Ameye Filip