Removing bladder cancer using a surgical robot

Ms. Hue occasionally had hematuria even though it was not painful. MSc. Nguyen Tan Cuong, Deputy Department of Urology, Center of Urology – Nephrology – Andrology, Tam Anh General Hospital, Ho Chi Minh City, noted a 3 cm tumor in the top of the patient’s bladder. Cystoscopy showed that the tumor was a widespread infiltrate into the bladder wall, and next to it was a small tumor about 5 mm, with no lymph nodes.

Doctor Cuong performed laparoscopic surgery to remove the bladder tumor through the patient’s urethra and also took a biopsy tissue sample for pathology. However, this method can only remove small tumors, while large tumors cannot be completely removed because they have penetrated deep into the bladder wall.

After laparoscopic surgery, Ms. Hue had the first dose of chemotherapy (immediate chemotherapy) injected into her bladder within the first 24 hours, killing remaining cancer cells.

Two weeks later, Ms. Hue had a follow-up examination, and pathology results showed that the malignant tumor in the bladder had invaded the muscle. Dr. Cuong said the best method is surgery to remove the entire bladder and divert urine out through the intestines. The patient wanted to keep his bladder, so the doctor prescribed surgery to remove the tumor and part of the bladder with the help of the Da Vinci Xi robot.

The surgery was favorable because Ms. Hue’s tumor was located alone, at the top of the bladder. The robot control team removes the part of the bladder with the tumor, retaining the patient’s healthy bladder, helping to preserve bladder function and recover faster than traditional open or laparoscopic surgery. After surgery, she returned to normal eating and drinking 5 days later.

Because the tumor was very invasive, the doctor scheduled her for a follow-up visit after a month to evaluate the condition. Additional chemotherapy or radiotherapy may be needed to destroy remaining cancer cells and reduce the risk of recurrence.

Vietnam has more than 1,900 new cases of bladder cancer in 2022 according to Globocan. High risk factors come from smoking, exposure to toxic chemicals, chronic inflammation or prolonged use of chemotherapy. Common symptoms of bladder cancer are intermittent hematuria, urinary disorders, pain in the lower abdomen, back, or fever, chills, weight loss, leg swelling…

When the disease is in the early stages, the doctor prescribes cutting the tumor through the urethra and infusing chemicals into the patient’s bladder. In advanced stages of the disease, total cystectomy or a combination of surgery or chemotherapy, radiotherapy, or additional treatments are needed depending on the stage. Bladder cancer has a high risk of recurrence even after treatment. Patients need to have regular check-ups as scheduled, every 3-6 months in the first 2 years for monitoring, early detection and timely treatment