Laparoscopic Surgery for Bladder Cancer

What does Laparoscopic Surgery Involve?

Laparoscopic surgery is a technique used in the treatment of bladder cancer before undertaking radical (or, on rare occasions, partial) cystectomy. The operation involves removing the bladder. Laparoscopic surgery is tending to replace open surgery in radical treatment of bladder cancer.

The procedure is performed when a tumour is invasive, i.e., more aggressive.

The main aim is the full removal of the tumour together with the whole organ (or part of it in the rare case of partial cystectomy). It is also necessary to remove the other adjacent organs.

What is the Laparoscopic Surgery Procedure?

Laparoscopic surgery is performed under general anaesthetic and consists of making small incisions (a few millimetres) in the patient’s abdominal wall through which instruments are inserted like a laparoscope, which allows the surgeon to perform the operation via a video monitor.

The technique is used to perform a cystectomy, i.e., the removal of the bladder.

Radical Cystectomy

If the tumour is invasive, large or has spread to various parts of the bladder, a radical cystectomy is necessary. In other words, the whole organ must be removed.

So that the urinary tract can still work – producing, storing and eliminating urine – reconstruction surgery is necessary.

These reconstructions can be of different types:

  • Creation of a new bladder made from the small intestine (ileum);
  • Incontinent diversion – in which the ureters (the tubes carrying urine from the kidneys) are attached to one of the sides of a section of the intestine (also usually a section of the ileum) and the other side to the skin. The patient thus has a “stoma”, (in this case called a urostomy).
  • Continent diversion – similar to the above but in which an intestinal pouch and a “valve” mechanism are created. This valve allows the patient to catheterise the pouch so that it can be emptied at regular intervals.

Radical cystectomy is accompanied by the removal of the prostate and seminal vesicles in men and the ovaries, fallopian tubes, uterus (including the neck) and a small part of the vagina in women. The lymph nodes near these organs are also removed.


Partial Cystectomy

This surgical procedure only removes the part of the bladder wall where the tumour is located.

One of the benefits is that the bladder is preserved. It therefore does not need later reconstruction. However, it can only be performed in very special cases due to the high risk of recurrence and evolution of the disease.

Furthermore, this change in the bladder implies a partial loss of volume and capacity to retain the same amount of urine as prior to the procedure. As a consequence, frequency of urination often increases.

Want to know more about this bladder cancer treatment?

Book a consultation at the Instituto da Próstata to find out all about this bladder cancer procedure.

What is the Post-Treatment for Cystectomy Like?

After undergoing a radical cystectomy, patients suffer some side effects and consequences that remain over time.

Men lose the ability to ejaculate semen/sperm. More worryingly, lesions appear on the nerves and vessels that enable penis enervation/irrigation, which generally causes erection problems (erectile dysfunction).

Women can feel a change in the ability to orgasm, as well as discomfort during sex.

These side effects are generally prolonged or indefinite in timescale.

Patients undergoing cystectomy must receive follow-up care for the rest of their lives with routine medical tests  - whether imaging exams, ultrasound and CT scans, or  tests that assess, among other things, kidney function, infection or changes to the so-called "hydroelectrolitic" and "acid-base" balance, as changes can occur to the levels of ions and other products in the body.

Dr. José Santos Dias

Clinical Director of the Instituto da Próstata

  • Bacherlor's Degree from the Faculty of Medicine at the University of Lisbon
  • Specialist in Urology
  • Fellow of the European Board of Urology
  • Autor dos livros "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" e "Protocolos de Urgência em Urologia"

FAQs about Laparoscopic Surgery for Bladder Cancer

What is laparoscopic bladder surgery?

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