Robotic-assisted surgery delivers watertight solution


Reconstructing a new bladder using a robotic approach is available for patients who have had their bladder removed.

Christine La Rose had initial surgery for what she thought might be a small benign lesion. Pathology results, however, found it to be a high-grade transitional cell carcinoma with the potential to penetrate the bladder wall.

“I was shocked,” recalled Christine who, at the age of 49, was in a low-risk category for bladder cancer. “I was fit, otherwise healthy and had no pain or other symptoms. It was blood in my urine that first prompted me to see my doctor.

“I knew that I would be looking at further treatment after receiving the pathology results. Dr Venu Chalasani referred me to Professor David Gillatt at Macquarie University Hospital to see if I was a candidate for the Hospital’s robotic program in urology.”

Professor Gillatt is a world-renowned prostate surgeon and Director of Medical Services at Macquarie University Hospital, which is now the busiest robotic prostate centre in New South Wales. Urology surgeons at Macquarie University Hospital use the Da Vinci Surgical System to perform a range of procedures. In Christine’s case, Professor Gillatt proposed complete removal of the bladder and the fashioning of a neo-bladder.

Christine underwent the procedure in June last year. “Traditionally this was performed using open surgical methods, which can result in more tissue and nerve damage, more blood loss and a greater risk of post-operative infection,” said Professor Gillatt.

“Now, we can perform both stages of this procedure robotically. We first remove the bladder, along with the uterus and ovaries. We then create a sphere-shaped pouch using the patient’s own small intestinal tissue inside the body, and attach it to the kidney and to the urethra.

“This is fantastic minimally invasive procedure, which also has greater precision. It’s an innovative stand-alone procedure that sees patients up and about within a day – much faster than after open surgery.”

Christine’s recovery has been remarkable. “If you looked at me today, you would never know I had a major operation. I feel 100 per cent. I have just a few tiny little scars left – and the occasional memory of what I went through. The new bladder functions just as my original one did.

“To think that if this minimally invasive approach hadn’t been available, I might have had a stoma with a bag for urine collection, or possibly long-term side-effects from open surgery. “The whole experience was amazing. I’m delighted but so is my family – they have their mum happy and healthy.” Neo-bladders are feasible life-long solutions for many patients.

“Most cases of neo-bladder are patients who have had their bladder removed due to cancer,” said Professor Gillatt. “And while bladder cancer generally affects older people, young people can also be at risk for the disease.

“My advice for women who have blood in their urine or recurring urinary tract infections is: don’t ignore it.
“Bladder cancer is treatable, and there are many different options available, with a robotic cystecomy and neo-bladder being just one of them.”

ABOUT MACQUARIE UNIVERSITY HOSPITAL’S ROBOTIC PROGRAM


Macquarie University Hospital has two robotic surgical systems: both Da Vinci Si Surgical System and the newer Da Vinci Xi platform that features several advanced features.

The robotic-assisted surgery program is spread across many disciplines, including urology, gynaecology, cardiothoracic, colorectal and upper GI.