Robotic Surgery Offers Minimally Invasive Option for Bladder and Kidney Cancer Surgeries
For patient referrals, please call the Referring Physician Resource Center at 866.742.4811, send an email to referral@stanfordmed.org or fax to 650.320.9443.
Advantages of robotic surgery
– Decreased blood loss
– Decreased need for blood transfusion
– Shorter hospital stay
– Less post-operative pain
– Shorter recovery
Just 10 short years ago, robotic surgery revolutionized
the removal of the prostate for patients with
prostate cancer. Today, that same minimally invasive procedure is being used for more complex
urologic cancers with the same result – tiny surgical
incisions, less pain and quicker recovery for patients.
Stanford moved to the forefront in robotic surgery for urologic
cancers in June of 2009 when it brought on Mark Gonzalgo,
MD, PhD, from The Johns Hopkins Brady Urological
Institute. Dr. Gonzalgo, who is now Program Director of the
Robotic-Assisted Urologic Cancer Surgery Program at Stanford,
is one of the few surgeons in the country to have substantial
experience in robotic cystectomy for bladder cancer.
Rounding out the robotic surgical team at Stanford are Benjamin
Chung, MD, Harcharan Gill, MD, John Leppert, MD,
and Joseph Liao, MD.
“Robotic surgery achieved its momentum with prostate
cancer,” says Gonzalgo, “Now it is being used for more
complex surgeries such as partial nephrectomies and bladder
cystectomies. It is also being increasingly utilized in other
fields such as gynecology and cardiology.”
Treating the most complex urologic cancers with robotics ...
Robotic/laparoscopic partial/radical nephrectomy –
Using the DaVinci robot, surgeons can remove sections of the
kidney or the entire kidney, with only a few small incisions in
the abdomen. In contrast, the traditional “open” procedure requires
an incision that is several inches long and typically results
in significant post-operative pain and a large surgical
scar. Many patients with kidney tumors may be candidates
for a partial nephrectomy, says Gonzalgo. The goal of the
Stanford robotic surgical team is to preserve as much of the
kidney as possible, while offering patients the same curative
rate as open surgery.
Robotic cystectomy with urinary diversion for bladder
cancer – This is the newest, most complex application for robotic
urological surgery, according to Gonzalgo, who is
among only a handful of surgeons in the United States to routinely
offer patients with bladder cancer this minimally invasive
option. Using the enhanced control and precision offered
by the robotic device, Gonzalgo can remove a patient’s tumor
and reconstruct the bladder with less morbidity than traditional
open surgery. There is less blood loss for patients and
a quicker recovery from surgery using this minimally invasive
method. This technique can be used for the majority of patients
with invasive bladder cancer.
Nerve-sparing robotic radical prostatectomy for prostate cancer – The robotic prostatectomy, or removal of the prostate, offers less post-operative pain and a shorter recovery period for patients. Today, more than 65% of prostates are removed via robotic-assisted devices.
“Robotic surgery gives patients an option they previously
did not have,” says Gonzalgo. Using robotics, patients can
have their cancer treated as effectively as with open surgery,
but recover more quickly. “Regardless of whether the surgeon
is using a robotic tool or conducting an open surgery, the goal
is the same,” says Gonzalgo, “to achieve a cure with the lowest
impact on a patient’s quality of life.”
Robots give surgeons added precision
“The DaVinci robot gives surgeons a level of dexterity and pinpoint
precision not available with laparoscopic techniques,” explains Gonzalgo. “The robotic hand mimics the wrist motion
of the surgeon, allowing him to tie sutures, remove tumors,
cut and sew”, he adds. Surgeons performing robotic
surgery are able to remove the cancer while preserving surrounding
nerves and tissues allowing patients to maintain a
high quality of life after surgery.
Working with referring providers.
For patients with complex urologic cancers, Stanford has a
multidisciplinary team of surgeons, radiation oncologists,
and medical oncologists who can provide post-operative
treatment. However, most patients return to their referring
physicians for follow-up care in their own community. After
surgery, Stanford surgeons communicate with referring
physicians to determine what type of follow-up care is
needed depending on the complexity of the patient’s condition.
Together, the referring physician, patient, and surgeon
determine where the patient will receive continued
treatment if necessary.
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