Southmead Hospital surgeons use robot to create a new bladder for cancer patients

Tuesday, 20 March 2012

Surgeons at Southmead Hospital are robotically constructing new bladders for cancer patients in a UK first.

The procedure, known as a radical cystectomy and neo-bladder, used to be performed manually in open surgery by surgeons creating a new bladder for cancer patients who had to have the organ removed.

Now Southmead Hospital, in Bristol, are making neo-bladders robotically from the patient’s own bowel tissue inside their body for the first time.

The keyhole surgery is less invasive, has a faster recovery time for patients.

A radical cystectomy involves removal of the bladder, prostate, seminal vesicles in men, and in women, also the uterus, cervix, urethra, anterior vaginal wall, and often the ovaries.

Traditionally this was performed using open surgical methods which could lead to more tissue and nerve damage, more blood loss and carry a greater risk of post-operative infection.

Robotic cystectomy is minimally invasive using our Da Vinci robot which has greater precision.

In 2008 Southmead Hospital became the first hospital in the South West to use a Da Vinci robot to carry out prostate removal for cancer patients. 

Since then the hospital has carried out more than 600 of these prostectomies.

It is now being used for radical cystectomy and partial nephrectomy (removal of small kidney tumours).   

Robotic neo-bladder procedure is being carried out by Southmead’s consultant urologists Edward Rowe and Anthony Koupparis.

Consultant urologist at Southmead Hospital Edward Rowe said: “The whole procedure is performed through keyhole surgery using the Da Vinci robot system.

“Having removed the bladder containing the tumour, we reconstruct a new bladder from the patient’s own bowel and attach this internally to the patient’s urethra allowing them to pass urine normally.

“Traditionally this is a major operation with a large incision but we hope that by using this minimal access route we can decrease the trauma to the patient enabling them to obtain a faster recovery and return to normal activity.

 “Patients can be home from hospital following this type of surgery within four to seven days and in six to eight weeks they can return to a normal quality of life.

“Our abilities to carry out urological procedures robotically is expanding all the time and we are developing a real expertise in this area. “

Ken Harries, 61, was the first person to have a new bladder constructed robotically at Southmead Hospital in October last year.

He was diagnosed with bladder cancer in May 2011 and following an operation to remove some of the cancerous tumour that was preventing his bladder from working properly he was referred to Mr Rowe at Southmead.

After a course of chemotherapy began to have side effects, Mr Harries was given the option of having his bladder removed and a neo-bladder created.

The day after the operation Mr Harries, from Downside, near Bath, was able to get up and walk about and returned to work in January. 

Mr Harries said: “My recovery was quite quick but it could have been quicker but I had a few set backs because I pushed myself too far.

“The only way I could look at it was to say I am going to beat this, and I am so glad I decided to go through with it.

“When I made my mind up to go for this new procedure I was calm about it because the team at Southmead were outstanding and filled me with confidence from day one.

 “It is amazing to think of the advances in medical techniques and the strides that are being made, this is the way forward and I was fortunate to have this service right here in Bristol.”

Find out more about the Urology team at Southmead Hospital and see the robot in action.