Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.
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Important Tips before Going for Minimal Invasive Robotic Radical Cystectomy for Bladder Cancer

15 Apr
By Dr. Anup Ramani

Bladder cancer surgery can be a challenging journey, especially for those with muscle-invasive bladder cancer. Minimal invasive robotic radical cystectomy is one of the most advanced treatments available for bladder cancer. It allows for the removal of the bladder while using cutting-edge robotic technology that reduces recovery time and complications.

However, preparing for this type of surgery requires more than just scheduling the procedure. Understanding what steps to take before surgery can help reduce anxiety, improve recovery and ensure the best possible outcome. If anyone planning for bladder cancer treatment in Mumbai or anywhere else, there are several important tips you should consider before undergoing robotic radical cystectomy.

Consult a Specialist: Choose the Right Bladder Cancer Surgeon

The first step in preparing for robotic radical cystectomy is choosing the right bladder cancer surgeon. This procedure requires a high level of expertise, particularly in robotic surgery, which is a highly specialized technique.

How to Select a Good Surgeon?

  • Experience: Look for a surgeon with extensive experience in robotic surgery for bladder removal. Surgeons who specialize in bladder cancer will have the knowledge to handle complications and tailor the surgery to your needs.
  • Success Rates: Ask about the surgeon’s success rate with robotic radical cystectomy and patient outcomes. The best surgeons will have positive feedback and a history of favorable results.
  • Comprehensive Care: A good surgeon will not only focus on the surgery but also provide post-operative care, managing potential complications and offering advice for a smooth recovery.

Take the time to meet with your surgeon, ask questions and ensure they have the experience and skills required for your specific needs.

Call for Bladder Cancer Surgeon

Preoperative Health Assessment: Be Thoroughly Evaluated

Before undergoing surgery, your surgeon will perform a comprehensive health evaluation to assess your suitability for minimal invasive robotic radical cystectomy. This helps in minimizing risks during the surgery and ensuring you are in the best shape for recovery.

Key Assessments to Expect:

  • Medical History Review: Be prepared to provide a complete medical history. This includes any past surgeries, current medications, allergies and lifestyle factors like smoking or alcohol use.
  • Imaging Tests: Your doctor may recommend imaging studies (CT scans, MRIs) to determine the extent of the cancer and check the health of surrounding organs.
  • Blood Tests: Blood work will be done to assess liver and kidney function and to ensure your body is prepared for surgery.
  • Cardiac Evaluation: If you have heart-related issues or are older, a cardiac assessment may be required to ensure your heart can tolerate the stress of surgery.
Proper preparation through these evaluations will help your healthcare team ensure a safer surgery with fewer complications.
Bladder Cancer

Follow Preoperative Instructions for Optimal Health

Your surgeon will provide specific instructions to help you prepare physically for the surgery. Adhering to these instructions is crucial to ensuring the best outcome for your surgery and recovery.

Preoperative Tips:

  • Smoking: If you smoke, try to quit well before the surgery. Smoking can delay healing and increase the risk of complications like infections.
  • Dietary Restrictions: You may be asked to fast for a certain period before surgery, typically starting the night before. Make sure to follow these guidelines to avoid complications during the procedure.
  • Medications: Discuss any current medications with your surgeon. Certain medications, such as blood thinners, may need to be stopped before surgery to reduce bleeding risks.
  • Physical Fitness: If possible, try to improve your fitness level before surgery. Walking or light exercises can improve your stamina and help with recovery post-surgery.
Following these preoperative instructions ensures that your body is in the best possible condition for surgery.

Prepare Emotionally and Mentally for the Surgery

The emotional and psychological impact of bladder cancer and its treatment is often overlooked. It’s normal to feel anxious or stressed before surgery, but mental preparation is just as important as physical preparation.

Mental Preparation Tips:

  • Understand the Procedure: Knowing what to expect before, during and after surgery can help reduce anxiety. Talk to your surgeon about the details of robotic radical cystectomy, including the benefits, risks and recovery expectations.
  • Seek Emotional Support: It can be helpful to talk to a counselor, join a support group or lean on family and friends. Understanding that it’s okay to feel nervous and seeking help when needed can aid in mental preparation.
  • Set Realistic Expectations: Recovery from bladder cancer surgery takes time and it’s important to manage expectations. Speak with your healthcare provider about the typical recovery timeline and what you may experience during the healing process.

Prepare for Recovery and Postoperative Care

Understanding the recovery process before surgery can help you prepare for life after robotic radical cystectomy. While the minimal invasive technique reduces recovery, time compared to traditional surgery, it’s still important to know what to expect and how to plan for a smooth recovery.

What You Need to Know About Postoperative Care?

  • Hospital Stay: You will likely spend 5-7 days in the hospital after surgery. During this time, your medical team will monitor your recovery, manage any pain and assist with the early stages of rehabilitation.
  • Pain Management: While robotic surgery generally results in less postoperative pain, your doctor will prescribe pain management to help ease discomfort during recovery.
  • Urinary Diversion: Depending on the procedure, a urinary diversion (such as a neobladder or ileal conduit) will be created to allow urine to be excreted. You’ll need to learn how to manage this change, including proper care for any catheters or stomas.
  • Physical Activity: Avoid heavy lifting or strenuous activities for 6-8 weeks after surgery. Gentle walking and light movement can help with circulation and speed up recovery.
  • Dietary Adjustments: Staying hydrated and following a balanced diet will help your body heal. Your doctor may recommend a specific diet to aid in your recovery.

Make sure you have a support system in place for post-surgery care, whether it’s family, friends or hired help.

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Ask About Potential Risks and Complications

Like any surgery, robotic radical cystectomy comes with risks. Understanding the potential complications beforehand will help you make informed decisions about the surgery and address any concerns with your surgeon.

Potential Risks of Robotic Cystectomy:

  • Infection: As with any surgery, there is a risk of infection, particularly at the incision sites or within the urinary tract.
  • Bleeding: Some bleeding is expected, but excessive bleeding may require further interventions.
  • Urinary Issues: Depending on the type of urinary diversion, you may experience incontinence or difficulty urinating. This can improve with time and proper management.
Discuss these risks with your surgeon and make sure you understand the steps taken to minimize these risks during surgery.

FAQs About Robotic Radical Cystectomy for Bladder Cancer

Robotic radical cystectomy is a minimal invasive surgery to remove the bladder, performed using robotic assistance for greater precision and faster recovery.

Prepare by following preoperative instructions, such as quitting smoking, fasting before the surgery and reviewing your medical history with your surgeon. Mental preparation and support are also important.

Recovery typically involves a 5-7 day hospital stay, pain management and adjusting to a new urinary diversion. Full recovery may take 6-8 weeks, with restrictions on physical activity.

Risks include infection, bleeding and urinary issues, but these are generally less frequent with robotic surgery compared to traditional open surgery.

Your surgeon will teach you how to care for your new urinary diversion, including managing any catheters or stomas and maintaining hydration.

Conclusion

Undergoing robotic radical cystectomy for bladder cancer is a significant decision, but with the right preparation, it can offer life-saving benefits and a smoother recovery process. By following these essential tips and choosing Dr. Anup Ramani as the best bladder cancer surgeon in Mumbai and understanding what to expect before the procedure, you can approach the surgery with confidence and readiness.

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Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.

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PARTIAL PENECTOMY
  • Partial penectomy is done in cases where glans and distal penis is involved with carcinoma. 
  • Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
  • Patients who develop stones in the kidney or ureter, often experience severe pain.
  • This condition usually needs a procedure to remove the kidney stones.
  • This procedure is called ureteroscopy and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
  • The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
  • The procedure takes about 40-50 minutes. 
  • A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is one night and patient is discharged the next day after removal of the catheter.
  • Patient has to come back after six weeks to remove the stent in the kidney.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
  • Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
  • This procedure is called TURP and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
  • The overgrown prostate is dissolved with a laser bloodlessly.
  • The procedure takes about 40 minutes.
  • A catheter (urine pipe) is kept after the procedure to drain the bladder.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR

  • Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.

  • Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.

  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).

  • Dr. Ramani then sits in the controlling console to perform the surgery.

  • On an average, a robotic adrenalectomy takes one hour.

  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.

  • A urine catheter and bag to drain the bladder is inserted during surgery.

  • A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.

  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.

  • The drain pipe, if kept, is removed in the room on day 2 after surgery.

  • The catheter is removed on day two after surgery.

  • Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).

  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.

RETURN TO ACTIVITY

  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.

  • Heavy activities like running, weight lifting can be resumed after a month

FOLLOW UP AFTER SURGERY

  • Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
    Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consultation.

ROBOTIC SURGERY FOR BLADDER CANCER
  • Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
  • Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
  • Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the new bladder is inserted during surgery.
  • Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
  • The drain pipes are removed in the room on day 3-5 after surgery.
  • Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
  • Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY

  • Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.

  • Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.

  • If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.

ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
  • Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
  • relatively easier but still requires significant experience to consistently deliver results.
  • Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the bladder is inserted during surgery.
  • A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
  • The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
  • Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self- sufficient. 
  • They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. 
  • Almost all patients are back to work within 2-3 weeks of surgery.
  • Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
  • Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
  • Local patients usually meet Dr. Ramani after two weeks to discuss report. 
  • Outstation patients are counselled on a phone consultation.