Recently, the urology team at Hainan Cancer Hospital completed a high-difficulty robotic-assisted radical cystectomy with ileal conduit urinary diversion and pelvic lymph node dissection.
On March 26th, the writer has learned from the hospital that Mr. Jiang, the patient, has been discharged successfully and has resumed a normal life.
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The elderly patient in his seventies was diagnosed with bladder cancer after experiencing recurrent hematuria
Mr. Jiang, a 74-year-old patient, visited the Urology Department of Hainan Cancer Hospital due to persistent hematuria. After undergoing relevant examinations such as pathological biopsy, he was diagnosed with invasive bladder cancer involving the muscular layer.
Director Qu Jun of the Urology Department explained that the bladder is an organ in the human body responsible for storing urine. It is closely connected to other organs such as the prostate, ureters, and seminal vesicles, collectively forming the male urinary system. Invasive bladder cancer involving the muscular layer has a high malignant degree, with a rapid growth rate and a tendency for recurrence and metastasis.
Currently, "radical cystectomy" is the preferred treatment for invasive bladder cancer involving the muscular layer. This surgical procedure involves the complete removal of the bladder and surrounding organs, as well as pelvic lymph node dissection. By "cutting the grass" and "removing the roots," the disease can be effectively controlled, and the patients survival time can be prolonged.
The bladder is located deep within the pelvic cavity, resulting in poor visibility and a confined space for surgical access. Additionally, radical cystectomy involves a wide resection range and complex surgical procedures. As a result, it has always been considered the most challenging surgery in urology.
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Human-machine collaboration enables surgery to achieve precision, accuracy, and stability
With its ultra-precise manoeuvrability and high-definition surgical field of view, the surgical robot possesses a significant advantage in complex urological surgeries that require delicate manipulation. After repeated discussions on Mr. Jiangs condition and the surgical difficulty, Qu Jun and his team have decided to perform robot-assisted "radical cystectomy with ileal conduit urinary diversion and pelvic lymph node dissection".
Recently, under the lead of Dr. Qujun, and with the assistance of Dr. Chen Ke and other physicians, the surgery proceeded smoothly.
During the surgery, Dr. Qujun utilized the 3D visualization technology of the surgical robot to accurately manipulate its agile robotic arms under the guidance of ultra-high-definition and wide-field images. This enabled the completion of complex procedures such as bladder and prostate resection, as well as pelvic lymph node dissection. Finally, a 20cm segment of the ileum was extracted to serve as a replacement for the bladder, and it was precisely connected to the ureters on both sides, reconstructing a new urinary system.
Postoperative observations revealed that Mr. Jiang did not experience any complications such as anastomotic leakage. His urination was smooth, indicating the successful outcome of the surgery.
Director Qujun operated the robotic arms by using 3D visualization technology.
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Robotic surgery has shown significant advantages with its remarkable assistance
Surgical robots are medical devices that integrate modern high-tech methods and have a wide range of applications. Director Qujun explained that robotic surgery possesses numerous unique technological advantages, allowing for precise operations that are beyond the reach of traditional manual surgery.
Director Qujun highlighted three significant advantages of robotic surgery.
The first advantage is a clear surgical field of view. The robotic surgical system provides a naked-eye 3D field of view, which helps the operating surgeon better understand anatomical relationships, protect normal tissues more effectively, and improve the accuracy and safety of the surgery.
The second advantage is greater flexibility in the surgical procedures. The robotic surgical system can perform flexible "wrist-like" movements, allowing it to accomplish actions that are difficult or impossible to achieve with conventional laparoscopic surgery. It can also reach "complex areas" that are challenging for human hands to access, effectively reducing patient trauma during surgery.
The third advantage is increased safety, efficiency, and comfort. In conventional surgeries, experts typically stand during the operation. Prolonged surgery duration can lead to fatigue and trembling in the arms. While performing robotic surgeries, experts can comfortably sit on a chair, which not only reduces fatigue but also effectively filters out trembling, making the surgical procedure safer and more efficient.
Preoperative preparation for robotic surgery
Introduction of the expert
Text from Chen Lin, and pictures from Li Hongyi