da Vinci Surgery
 

Bladder Cancer

The bladder is a hollow organ that stores urine. It is located inside the lower abdomen, is about the size of a grapefruit and is distensible (elastic) which allows its muscular wall to get larger and smaller. Bladder cancer is a disease in which cancer cells form in the tissues of the bladder.

Cancer of the bladder is the ninth most common cancer worldwide with approximately 350,000 new cases per year; it claims roughly 145,000 lives annually.1 Rates in men are three to four times greater than in women and bladder cancer is more common in many southern and eastern European countries, parts of Africa, the Middle East and North America.1

Treatment Options

Treatment options depend on the stage of bladder cancer (Stage 0 to Stage 4). There are four standard treatment options for bladder cancer:

  • Surgery
  • Radiation
  • Chemotherapy
  • Biologic Therapy

It is important to discuss all treatments and surgical options with your doctor before deciding which is best for your individual situation.

Bladder Surgery

A cystectomy is the removal of all or part of the bladder and possibly the removal of nearby lymph nodes and organs that may contain cancer. If the bladder is removed, the surgeon creates a new path for urine to be stored and to leave the body.

Open Surgery

Cystectomy – removal of the bladder - can be performed using open surgery. Open surgery, also called laparotomy, is any surgical procedure in which a large cut/incision is made to reach your organs. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your body. While open surgery allows your surgeon to see and touch your organs, it is invasive and can be traumatic on your body due to the large incision.

Minimally Invasive Surgery

Traditional Laparoscopy

Laparoscopic surgery is minimally invasive – meaning surgeons operate through a few small incisions. During traditional laparoscopy, long-handled surgical instruments are inserted through the incisions. One of the instruments is a laparoscope – a thin, lighted tube with a tiny camera at the end. The camera takes images inside your body and those images are sent to a video monitor to guide surgeons as they operate.

da Vinci® Surgery

With the da Vinci System, surgeons make just a few small incisions instead of a large open incision - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your doctor to operate with enhanced vision, precision, dexterity and control.

da Vinci is a minimally invasive approach that uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.

Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells either by killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy) When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Bladder cancer may be treated with intravesical (into the bladder through a tube inserted into the urethra) chemotherapy. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Biologic therapy

Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

PN 1002317 Rev A 04/2013
  1. Parkin DM; The global burden of urinary bladder cancer. Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Old Road Campus, Headington, Oxford, UK. max.parkin@ctsu.ox.ac.uk Available from: http://www.ncbi.nlm.nih.gov/pubmed/19054893

All surgery presents risk, including da Vinci® Surgery and other minimally invasive procedures.  Serious complications may occur in any surgery, up to and including death. Examples of serious or life-threatening complications which may require hospitalization include injury to tissues or organs, bleeding, infection or internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Risks of surgery also include potential for equipment failure and human error. Risks specific to minimally invasive surgery may include: A long operation and time under anesthesia, conversion to another technique or the need for additional or larger incisions.  If your surgeon needs to convert the procedure, it could mean a long operative time with additional time under anesthesia and increased complications. Temporary pain or discomfort may result from pneumoperitoneum, the presence of air or gas in the abdominal cavity used by surgeons in minimally invasive surgery. Research suggests that there could be an increased risk of incision-site hernia with single-incision surgery. Results, including cosmetic results, may vary.  Patients who bleed easily, who have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci® Surgery. For more complete information on surgical risks, safety, and indications for use, please refer to http://www.davincisurgery.com/safety/. Patients should talk to their doctors about their surgical experience and to decide if da Vinci Surgery is right for them. Other options may be available. Intuitive Surgical reviews clinical literature from the highest level of evidence available to provide benefit and risk information about use of the da Vinci Surgical System in specific representative procedures. We encourage patients and physicians to review all available information on surgical options and treatment in order to make an informed decision. Clinical studies are available through the National Library of Medicine at www.ncbi.nlm.nih.gov/pubmed.

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