Robotic Removal and Recovery Reviewed

Advanced technology has become very popular in the surgery suite. Even robotic arms are in there helping surgeons these days. This high tech surgery has been found to be easier on the patient.

A new study showed that, compared to open surgery, patients recover more easily when robotic-assisted surgery technology is used to treat invasive bladder cancer.

Talk to your doctor about the specifics of any surgical procedures.

When bladder cancer has gone into the muscle, an operation is performed to remove the whole bladder. That operation is called a cystectomy. So far in 2012, 73,500 American have been diagnosed with bladder cancer.

This study compared how well patients did with robotic-assisted laparoscopic radical cystectomy (RARC) compared with traditional open radical cystectomy (ORC).

Dipen J. Parekh, MD, professor and chairman of the University of Miami Miller School of Medicine's Department of Urology and director of robotic surgery, served as the lead investigator for this small study. The randomized trial involved 47 patients who received either ORC or RARC. Participants in both groups were similar in terms of demographics – age, gender and race.

Investigators measured post-surgical factors for each of the patients, including blood loss, operation duration, what transfusions were needed, complications after the surgery and how long the individual stayed in the hospital.

The authors reported that those who received robotic-assisted surgery had less blood loss than those who received open surgery. The high tech group also tended to recover more quickly and had shorter hospital stays. These folks also saw a faster return of bowel function and they needed fewer transfusions than folks in the ORC group.

"The strength of our study is the prospective randomized nature that eliminates selection biases that may have been present in prior retrospective analyses," Dr. Parekh said in a statement. He thinks the next step would be a prospective randomized trial to compare the techniques.

According to an article in the New England Journal of Medicine, an open radical cystectomy costs about $32,000. When robotics are used to assist, the cost goes up by about $1,600.

Dr. Parekh’s team is collaborating with other institutions to evaluate the two different approaches. This study will collect and analyze data collected over a period of time. Researchers will look at everything from quality of life issues, daily function, mobility and lifespan.

The findings of this study are published in the February 2013 issue of The Journal of Urology. No conflicts of interest were reported.