How should I prepare for my surgery?
When you come to Roswell Park for a consultation you will provide us with information that we will need to make sure we can do the best possible job. Some of that information we need you to provide includes an up to date list of your medications, previous surgeries, allergies, and current medical conditions.
How long is my surgery, and how long do I stay in the hospital?
The amount of time the surgery takes can vary from patient to patient but our statistics show that the median (midpoint of a range of numbers that are arranged in order) is 8 days.
Is blood loss a concern?
During major surgery like RARC, loss of blood is a concern. If someone loses too much blood during surgery, a blood transfusion may be needed to make up for what’s been lost. RARC is beneficial in the fact that there is less blood loss than traditional open surgery.
What else is removed with my bladder?
Open or robot-assisted radical cystectomy includes removing the bladder (and prostate gland and the seminal vesicles for men). The lymph nodes in the pelvis are removed as well.
What do I go home with?
The type of urinary diversion performed will determine the post operative care. If an ileal conduit is created through reconstructive surgery in which the urine will drain directly from a piece of intestine, and a drainage bag will be needed to collect the urine. If a “neo bladder” (new bladder) is created internally out of intestinal materials, the patient will go home with a Foley catheter in order to drain the urine and depending on the surgery an abdominal drain as well. These usually remain in place until the first follow up appointment.
It’s unusual to require pain medicine when the patient leaves the hospital, but we prescribe a small amount of pain medicine just in case.
When will I follow up with my doctor?
Upon discharge from the hospital a follow up appointment is typically 9 – 10 days after surgery. At this appointment we discuss the results of the surgery. From this we can determine whether additional treatments are needed, and if any of the lymph nodes contained cancer.
Are there any surgical alternatives to Robot Assisted Radical Cystectomy?
Alternatives to robotic surgery include open surgery, observation or a combination of chemotherapy, radiation and transurethral bladder tumor resection (scraping). Removal of the bladder either via robotic surgery or open surgery is the standard of care for locally advanced tumors. If you chose to have surgery for your bladder cancer the surgeon (urologist) will discuss the different ways to perform the operation.
Surgery to remove the bladder for invasive cancer is called a “radical cystectomy.” Surgery can be performed in the traditional “open” way in which large incisions (cuts) have to be made to allow the surgeon to remove the bladder. This is called an “open radical cystectomy.”
What will I need to do after surgery?
Each day following surgery, you will feel better. A few tips to aid you in the recovery process are as follows. If there is no dressing on your incision, clean it daily with soap and water. Increase your activity daily – walk outdoors and use the stairs. When sitting, prop your feet up on a stool or sit on a recliner to prevent swelling in your legs. If swelling occurs, lie in bed and raise your feet on pillows so they are higher than your head. Do not lift anything heavier than 5 pounds, and be sure to continue using the incentive spirometer. Return to your normal diet, but try to eat foods high in fiber. Also drink 5-6 glasses of water or juice daily.