daVinci Robotic Radical Cystectomy FAQs
What is the diagnosis or pathology being treated by this procedure or surgery?
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The most common reason for a radical cystectomy is for treatment of bladder cancer. Less common are benign reasons for bladder removal such as radiation cystitis or neurogenic bladder or chronic inflammation/infections in the bladder.
Can you describe the procedure or draw a picture?
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Using the daVinci robotic technique the bladder is removed. Depending on the gender of the patient more than the bladder must be taken out to completely have a successful cancer operation. In the male the prostate and seminal vesicles are removed and occasionally the urethra. In the female the bladder, anterior vaginal wall, uterus, ovaries are all removed to ensure adequate removal of the the cancer.
The cancer operation also involves lymph nodes dissection. Possible lymph nodes packets being removed are along the external, obturator and sometimes the common iliac node packets.
After bladder removal the urine is diverted typically using a segment of small intestine either into a conduit (stoma/bag on the outside of the abdomen), or to a form of continent diversion either as a neobladder connected to the urethra or catheterizable pouch.
What are the benefits of doing this procedure?
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The goal of this operation is complete removal of the bladder cancer.
What are the risks of doing the procedure?
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This procedure is one of the most complicated procedures done by a urologist. Complications are common.
Bleeding: Bleeding is common. Blood transfusion rates are not common.
Infection: Infections are common with this operation. The bowel reconstruction required exposes many bacteria to the incision and to the urinary tract.
Ileus: The small intestine often takes a few days to wake up after surgery. This results in an ileum, with bloating and gas buildup in the intestines.
Blood Clots: Deep venous thrombosis is common with this prolonged operation. Early ambulation is important to keep circulation.
Ureteral Stricture: Stricture at the level of the uretero-intestinal anastomosis is a common complication after the surgery.
Lymphocele
Anesthetic Complication
Cancer Recurrence
Stoma Complications
Are there alternatives to this procedure I should be considering?
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The alternative to bladder removal is bladder sparing techniques using radiation and chemotherapy along with deep resection done transurethral to remove the bulk of the tumor from the bladder.
Prior to consider alternatives, patients should be aware chemotherapy is often employed prior to a cystectomy, known as neoadjuvant chemotherapy. This has shown survival and cancer control benefits.
Very infrequently muscle invasive bladder cancer can be cured with deep resection of the tumor transurethral without any chemotherapy or radiation therapy. Patients and physicians should be very careful before choosing this option.
Is this a common procedure?
This procedure is done commonly by Minnesota Urology physicians but many smaller urology practices no longer do this large of an operation.
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Should I do the procedure now or what happens if I wait to do the procedure?
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You should do the operation as soon as possible. The operation is often delayed until after neoadjuvant chemotherapy.
How do I prepare for this surgery?
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You will see your primary physician and other specialists for preoperative clearance. You will stop blood thinning agents at appropriate time. You will be asked to do a bowel preparation prior to your surgery. You will se a stoma nurse prior to the surgery for education and marking of the urinary diversion.
How do I recover from this procedure?
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Hospital stay: 4–10 days, depending on recovery and complications.
You will have IV or oral pain medicines. Expectone or more abdominal drains. Early walking (same day or next day) is encouraged to lower risk of blood clots and lung problems.Diet advances from clear liquids to solid food as tolerated. Expect some bloating and constipation; stool softeners and laxatives are commonly used.
Recovery at home (2–12 weeks)
Activity: Avoid heavy lifting and strenuous activity for 6–8 weeks (sometimes longer if hernia repair or complications). Gradually increase walking and light activity. Return to driving when off narcotic pain meds and able to sit and brake safely.
Wound care: Keep incisions clean and dry. Follow surgeon’s instructions about showering and dressing changes. Watch for redness, increased pain, pus, or fever—signs of infection.
Stoma and pouch care: If you have a urostomy, you’ll learn pouch care before discharge. Expect an adjustment period for appliance fitting and skin care. If you have a continent reservoir or neobladder, your team will teach catheterization, emptying routines, or pelvic floor exercises.
Catheters and drains: You may go home with a ureteral stent, suprapubic tube, or urethral catheter. These are removed or exchanged per schedule in clinic.
Diet and digestion: High-fiber diet, adequate fluids, and stool softeners help prevent constipation. Gradually return to your normal diet unless advised otherwise.
Pain and medications: Pain usually improves over weeks. Use prescribed pain meds as directed and transition to acetaminophen/NSAIDs when possible. You may need antibiotics, blood clot prevention injections, or medications to manage stoma output.
Is this procedure covered by insurance?
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Yes, this procedure is covered by insurance.