Cystectomy: Types and Procedures Explained

 Cystectomy is a surgical procedure that involves the removal of the bladder, and sometimes adjacent organs or tissues, to treat conditions like bladder cancer, severe bladder dysfunction, or injury. This comprehensive blog will explore the different types of cystectomy and the associated procedures, shedding light on the diverse approaches to this critical surgery.

Types of Cystectomy:

1. Radical Cystectomy:

• Radical cystectomy is the most extensive type of bladder removal surgery.
• It involves the complete removal of the bladder, surrounding lymph nodes, and, in some cases, adjacent organs such as the prostate in men or the uterus and ovaries in women.
• This procedure is primarily employed for advanced bladder cancer cases.

2. Partial Cystectomy:

• In certain situations, where the cancer is confined to a specific area of the bladder, a partial cystectomy may be performed.
• Only the affected part of the bladder is removed, preserving the rest of the organ.
• This approach is suitable for early-stage cancer patients or those with limited bladder dysfunction.

3. Radical Cystectomy with Urinary Diversion:

• Radical cystectomy is often accompanied by urinary diversion procedures to reroute urine and maintain urinary function.
• The choice of urinary diversion method depends on factors such as the patient’s overall health and the surgeon’s expertise.
• Common urinary diversion options include ileal conduit, neobladder, and continent cutaneous reservoir.

Cystectomy Procedures:

1. Open Surgery:

• Traditional open surgery involves a large abdominal incision.
• While effective, it is associated with a longer recovery time and a higher risk of complications.
• Open surgery may be preferred when minimally invasive approaches are not suitable for a patient’s specific case.

2. Minimally Invasive Surgery:

• Laparoscopic and robotic-assisted techniques have revolutionized cystectomy.
• These procedures involve smaller incisions, leading to reduced pain, shorter hospital stays, and faster recovery.
• Robotic-assisted cystectomy allows for greater precision and maneuverability during surgery.

3. Urinary Diversion Techniques:

• Ileal Conduit: This technique creates a stoma on the abdomen, and urine is collected in an external pouch.
• Neobladder: A new bladder is fashioned using a portion of the small intestine, facilitating more natural urine storage and release.
• Continent Cutaneous Reservoir: This approach involves the creation of an internal pouch, which can be catheterized periodically to empty urine.

Conclusion:

Cystectomy is a critical surgical procedure with various types and approaches tailored to individual needs. Advances in minimally invasive techniques have significantly improved patient outcomes and quality of life. However, the choice of cystectomy type and procedure should be made in consultation with a medical professional, taking into account the patient’s specific condition and overall health.