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Bladder Cancer Treatment

(Muscle-invasive Bladder Cancer)

Muscle-invasive bladder cancer refers to cancer that has spread into the muscle wall of your bladder. Your doctor may recommend surgery to remove your bladder for this type of cancer or for bladder cancer that has returned. Surgery to remove the bladder is called a radical cystectomy.

What to Expect

Besides removing your bladder, surgeons may also need to remove lymph nodes and nearby organs if they contain cancer. In men, the nearby organs that may need to be removed are the prostate and seminal vesicles (glands that produce semen). In women, your surgeon may need to remove your uterus, ovaries and part of the vagina.

Your surgeon will also create a new channel for urine to pass from your body. Options may include a neobladder (new reservoir made of part of your intestine) an ostomy bag connected to your urethra through an opening (stoma) in your stomach. Depending on the surgical approach used, your surgeon may still need to create a stoma. You may also need to use a catheter to release urine several times a day.1

Even if your surgeon removes all of the cancer that can be seen during surgery, you may have to undergo chemotherapy to kill any cancer cells that could be left behind. In fact, research shows chemotherapy before or after a radical cystectomy may improve survival for men with muscle-invasive bladder cancer.2

Surgical options:

Open Surgery

Bladder cancer surgery is typically done using traditional 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 remove your bladder.

da Vinci® Surgery

With the da Vinci® Surgical System, surgeons operate through a few small incisions instead of a large incision used in open surgery - 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 surgeon to operate with enhanced vision, precision, dexterity and control.

State-of-the-art da Vinci 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.

  1. American Cancer Society. Detailed Guide: Bladder Cancer Surgery. www.Cancer.org http://www.cancer.org/cancer/bladdercancer/detailedguide/bladder-cancer-treating-general-info
  2. American Society of Clinical Oncology. Bladder Cancer - Treatment. Cancer.net. www.cancer.net. www.cancer.net/patient/Cancer+Types/Bladder+Cancer?sectionTitle=Treatment.
  3. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Nguyen PL, Choueiri TK, Kibel AS, Hu JC. Comparative Analysis of Outcomes and Costs Following Open Radical Cystectomy Versus Robot-Assisted Laparoscopic Radical Cystectomy: Results From the US Nationwide Inpatient Sample. Eur Urol. 2012 Jun;61(6):1239-44. Epub 2012 Mar 30.

PN 1002148 Rev A 04/2013

Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci ® Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci® Surgery. Patients should talk to their doctor to decide if da Vinci ® Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

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