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 depend on the stage of bladder cancer (Stage 0 to Stage 4). There are four standard treatment options for bladder cancer:
- Biologic Therapy
It is important to discuss all treatments and surgical options with your doctor before deciding which is best for your individual situation.
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.
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
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 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 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 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.
- 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. firstname.lastname@example.org Available from: http://www.ncbi.nlm.nih.gov/pubmed/19054893
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and 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. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.
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PN 1002317 Rev A 04/2013 U 07/06/2012