Arguably the most difficult operation in urologic surgery is removing the bladder in women for bladder cancer. Our team was the first in the tri-state (NJ, lower NY, CT) area to perform this procedure with the da Vinci robot.
We performed our first robotic anterior exenteration (removing the bladder, urethra, and gynecological organs) in November for muscle invasive bladder cancer. There was very little blood loss (less than 100 ccs or 3 1/2 ozs)and a small incision to perform the urinary diversion and to remove the bladder and other organs in a sac.
We then performed what we believe to be the first robotic procedure for urethral cancer, an operation that is similar to that for bladder cancer, but requires special attention to the urethral area as the margin for cancer control is more difficult to establish. Our second patient also had minimal blood loss.
A review of the literature reveals very few cases like this being done robotically or laparoscopically. The largest laparoscopic series is from the Cleveland Clinic.
The largest series for robotic cystectomies is from Henry Ford in Detroit and Dr. Menon.
Our 2 patients were discharged home in 8 days and 5 days without any complications.
In our hands, we believe most bladder and urethral cancers will be approached robotically and plan on publishing our results.
We think the blood loss is significantly less similar to our experience with robotic prostatectomy and the recovery should be quicker.