Our Summary

This research paper reviews the use of robots in urinary diversion surgeries, a procedure typically required for bladder cancer patients. It discusses the history of the technique and its current status, comparing the outcomes of traditional open surgery and robot-assisted surgery. Various types of urinary diversions and techniques are explored, including extracorporeal (outside the body) and intracorporeal (inside the body) methods. Although most surgeries still use the extracorporeal approach, the use of the intracorporeal method is on the rise, promising some potential benefits. The paper identifies that while the use of robots may increase surgery times, the complication rates are similar to traditional methods. The study concludes that as experience with robotic methods grows, it is likely that these techniques will become more prevalent.

FAQs

  1. What is urinary diversion surgery and why is it typically required?
  2. How do the outcomes of traditional open surgery compare to robot-assisted urinary diversion surgery?
  3. What are the potential benefits of using the intracorporeal method in urinary diversion surgeries?

Doctor’s Tip

A doctor might tell a patient undergoing urinary diversion surgery to follow post-operative care instructions closely, including keeping the stoma clean and dry, monitoring for signs of infection, and staying hydrated to prevent urinary tract complications. It is important to attend follow-up appointments and communicate any concerns or changes in symptoms to the healthcare provider. Additionally, maintaining a healthy lifestyle through proper nutrition and regular exercise can help support the healing process and overall well-being after surgery.

Suitable For

Patients who are typically recommended for urinary diversion surgery include those who have:

  1. Bladder cancer: This is the most common reason for urinary diversion surgery, as removing the bladder is often necessary to treat the cancer.

  2. Neurogenic bladder: Patients with nerve damage that affects the bladder’s ability to function may require urinary diversion surgery to manage their condition.

  3. Congenital abnormalities: Some patients are born with structural abnormalities in their urinary tract that require surgical intervention to divert urine away from the bladder.

  4. Intractable bladder pain: For some patients with chronic bladder pain that is unresponsive to other treatments, urinary diversion surgery may be recommended to alleviate symptoms.

  5. Bladder dysfunction: Patients with severe bladder dysfunction, such as recurrent urinary tract infections or urinary incontinence, may benefit from urinary diversion surgery to improve their quality of life.

Overall, urinary diversion surgery is recommended for patients who have conditions that cannot be effectively managed with other treatments and require a surgical solution to redirect urine flow away from the bladder.

Timeline

Before urinary diversion surgery:

  1. Initial consultation with a urologist to discuss the need for surgery and treatment options.
  2. Pre-operative tests and evaluations to assess the patient’s overall health and suitability for surgery.
  3. Preparing for surgery, which may include dietary restrictions and medication adjustments.
  4. Admittance to the hospital on the day of surgery.

After urinary diversion surgery:

  1. Recovery in the hospital for a period of time, typically a few days to a week.
  2. Monitoring for any post-operative complications or issues.
  3. Learning how to care for and manage the urinary diversion, including emptying and cleaning the pouch or stoma.
  4. Follow-up appointments with the urologist to monitor healing and adjust treatment as needed.
  5. Adjusting to life with a urinary diversion, including potential lifestyle changes and adjustments.
  6. Long-term follow-up care to monitor for any potential complications or issues related to the surgery.

What to Ask Your Doctor

  1. What are the different types of urinary diversion surgeries available and which one is recommended for me?
  2. What are the potential risks and complications associated with urinary diversion surgery?
  3. How long is the recovery process and what can I expect during the recovery period?
  4. Will I need any additional treatments or follow-up care after the surgery?
  5. How experienced are you in performing urinary diversion surgeries, particularly using robotic techniques?
  6. What are the success rates of robotic-assisted urinary diversion surgery compared to traditional open surgery?
  7. How will my quality of life be impacted after the surgery, particularly in terms of bladder function and continence?
  8. Are there any lifestyle changes or dietary restrictions I will need to follow post-surgery?
  9. Are there any alternative treatments or procedures that I should consider before deciding on urinary diversion surgery?
  10. Can you provide me with any resources or support groups for patients who have undergone urinary diversion surgery?

Reference

Authors: Cacciamani GE, Rajarubendra N, Artibani W, Gill IS. Journal: Curr Opin Urol. 2019 May;29(3):293-300. doi: 10.1097/MOU.0000000000000592. PMID: 30762669