As one of the common malignant tumors of the urinary system, bladder cancer needs to undergo urinary diversion after surgery, commonly known as "carrying urine bags", which brings a lot of inconvenience to life.
Recently, the Department of General Surgery of the First People's Hospital of Guangzhou (hereinafter referred to as the "First People's Hospital"), with the assistance of a laparoscopic robot, successfully performed laparoscopic cystectomy and ileal orthotopic neobladder surgery for a bladder cancer patient, which preserved the patient's physiological function to the greatest extent and eliminated the patient's suffering from "carrying a urine bag".
Mr. Zhao, 74, was diagnosed with bladder cancer and came to the Department of General Surgery of a hospital in the city. After a comprehensive evaluation, the surgical team determined the surgical plan of "laparoscopic robot-assisted operation + laparoscopic cystectomy + ileal neocystectomy in situ".
Xiong Siwei, director of the Department of General Surgery of the First Municipal Hospital, said that Mr. Zhao suffered from high-grade muscle-invasive bladder cancer in situ, and the survival time may be shorter after receiving traditional **. Robot-assisted technology can help doctors remove the tumor completely, minimizing trauma and avoiding complications. At the same time, ileal orthotopic neobladder surgery can maximize the preservation of the patient's spontaneous urinary storage, voiding, and continence.
Therefore, the surgical modality of choice for this cancer is robotic-assisted laparoscopic cystectomy, as well as bilateral pelvic lymph node dissection and ileal neocystectomy. "The first cystectomy and bilateral pelvic lymph node dissection steps completed by robot-assisted laparoscopy laid the foundation for the operation. He said.
Xiong Siwei introduced that after the cystectomy, the doctor made a 6-centimeter incision in Mr. Zhao's lower abdomen, took out the bladder and other tissues, pulled the ureter and intestinal tube out of the body, and intercepted a 50-60 cm ileum from about 25 cm away from the ileocecal part (the part where the end of the ileum and the cecum meet), and constructed this ileum into an allantocyst, that is, a new bladder, through incision, folding, suturing and other steps. After that, the ureters on both sides are implanted into the new bladder to re-establish the pneumoperitoneum.
The last and most critical step of the surgery is the use of robotic-assisted technology again to anastomosis the neobladder to the urethral stump. "The advantage of this procedure is that the patient can urinate spontaneously as before the procedure, eliminating the pain of using a pouch for life. Xiong Siwei said.
The surgical team performs robotic surgical operations.
Today, Mr. Zhao's new bladder has retained its functions of urine storage, urination and continence, and he has basically returned to his normal life. Xiong Siwei said that surgical intervention on tumors that preserve physiological functions is of great significance to improve the prognosis of patients and improve their quality of life. In the future, the hospital will provide patients with more comprehensive solutions.
Southern + reporter Li Sixuan.
Correspondent: Wei Xing.
Author] Li Sixuan.
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