Lifewatch: Using robots for bladder cancer

Reported by Claire Hosmann - bio|email
Posted by Debra Worley - email

(WECT) - The National Cancer Institute expects there will be nearly 80,000 cases of bladder cancer this year alone.

Now, doctors have turned to robots to help them fight this battle by removing diseased organs and building new ones inside the body.  It's an option that boosts the chances of survival for patients who lose an organ to cancer.

Daniel Leherman's battle with bladder cancer began nine years ago.  He fought and won twice, but then it came back a third time.

Surgeons needed to remove his bladder to boost his chance of surviving.  They used a robot not only to pull out the diseased organ, but to build him a new one as well.

"It's six operations put together as a package deal," said Dr. Murugesan Manoharan.  "The idea is to have less pain for the patient, faster ambulation, and the patient can go home sooner and get back to their life."

Doctors pulled out the cancerous bladder through a two-inch incision.  Surgeons then directed the robot to cut a two-foot piece of the small intestine, fold it over, and stitch it into a new bladder all inside Daniel's body.

"If you use their own tissue, there's no question of rejection," said Manoharan.

It improved Daniel's odds dramatically.

"When the odds go from 70 to 80 percent chance of recurrence down to 10 percent, most people, myself included, go, 'Hey, those are nice numbers!'" said Daniel.

With the robot, doctors expect patients to stay in the hospital for a shorter length of time and return to work sooner than with open surgery.

For more information, please contact:
Lisa Worley
Media Relations
University of Miami Miller School of Medicine
(305) 243-5184

BACKGROUND: The National Cancer Institute expects there will be 70,980 new cases of bladder cancer and 14,330 deaths in 2009. Bladder cancer is a type of cancer that originates in the bladder. The cancer usually originates along the thin lining of cells on the inside of the bladder and is likely to be found in its early stages, according to the Mayo Clinic.  Bladder cancer usually affects older adults and has a high rate of recurrence.

Some of the leading symptoms of bladder cancer are blood in urine, painful urination, frequent urination, abdominal pain, back pain and urinary tract infections. People who smoke; are exposed to certain substances at work like rubber, certain dyes, paint and hairdressing supplies; eat a diet high in fried meats and fat; are older, male or white; or have had an infection caused by a parasite are at higher risk for bladder cancer than the general population, according to the National Cancer Institute.

TREATMENT: Early stage treatments include removing the tumor through surgery. TURBT, used for cancer confined to the inner wall of the bladder, is a surgery that uses a small wire loop through the urethra and into the bladder that burns away cancer cells. Surgeons can also remove the tumor and a portion of the bladder through a partial cystectomy. If cancer has invaded the deeper layers of the bladder wall, surgery to remove the entire bladder is an option as well as surgery to create a new way for urine to leave the body. Some other treatments include biological therapy; immunotherapy, which works by signaling your body's immune system to fight off the cancer; chemotherapy, which involves using a combination of drugs inserted through the veins to kill cancer cells that remain after surgery; and radiation.

SURGERY & BUILDING BLADDERS WITH ROBOTS: Technology advances have made it possible for robots to now remove bladder tumors and rebuild them inside the body. The University of Miami Leonard M. Miller School of Medicine is one of the first schools to use robotic technology to build new bladders inside the body. Murugesan Manoharan, M.D., an associate professor of urology at the University of Miami, says using the robot has advantages such as preciseness, less pain, less bleeding, shorter recovery time and fewer complications. The Da Vinci Surgical System robot can be used to remove a cancerous bladder through a small incision near the patient's abdomen, then rebuild a new bladder during the same surgery. Costs vary by patient, but most private insurance plans cover costs for the operation.

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