The Pros & Cons of Robotic Bladder Cancer Surgery

Robotic-assisted surgical removal of the bladder is becoming increasingly popular for treating bladder cancer, despite being more expensive than traditional surgery. Benefits of the robotic approach include smaller incisions and less blood loss for patients. In addition, surgeons have a better three-dimensional view and more freedom of wrist movement when compared with conventional laparoscopy. The procedure eliminates hand tremors, making tasks like suturing easier. However, robotic surgery for this patient group is fairly new. We’re only now beginning to gather larger, more comprehensive studies comparing outcomes of traditional open surgeries with robot-assisted procedures. [polldaddy poll=7559190] A New Analysis: Robotic Surgery In the March 30, 2012 issue of European Urology, my colleagues and I had a study  published that compared perioperative outcomes and costs of open robot-assisted laparoscopic radical cystectomy. Previous comparisons have been limited to reports from high-volume referral centers and have not made direct comparisons with regard to inpatient morbidity and mortality, lengths of stay, and costs. Using a national database of in-patient information from 1,050 hospitals in 44 states, our research team examined 1,444 traditional open surgeries and 224 robotic-assisted laparoscopic procedures in 2009. Robotic surgery for bladder cancer resulted in fewer deaths during hospitalization (0% vs 2.5%) and fewer in-patient complications (49.1% vs 63.8%) when compared with open surgery. It also reduced the need for intravenous nutrition after the procedure (6.4% vs 13.3%). Patients who underwent both types of surgery spent about 8 days in the hospital. Costs of Robot-Assisted Cystectomy The costs for robot-assisted laparoscopic radical cystectomy were significantly higher, amounting to nearly $3,800 more than traditional open surgery. This may be due to longer...