Application of Minimally Invasive Surgeries

Superficial bladder cancer has a high chance of cure. Treatment does not require open surgery, but needs an endoscopic resection through the urethra under anesthesia. Another interesting feature of superficial bladder cancer is its high recurrence rate. This is why patients need regular endoscopic surveillance and intravesical therapy. The most frequently used intravesical agent is BCG, which leads to an immunotherapy. BCG has been shown to reduce recurrence rates in clinical studies.

On the other hand, open surgery is needed in case the muscle layer is involved by cancer cells. Nowadays, even this type of major surgery can be accomplished by the minimally invasive approach, through a few small incisions. Post-operatively, patients need a stoma for urine collection, though some patients are suitable for bladder reconstruction.

Some patients with bladder cancer do habour another tumour in their kidneys at the same time. This is the reason that patients with bladder cancer need imaging for their kidneys. In case a kidney cancer is found, it has to be resected. This can also be carried out with minimally invasive method. The pneumovesicum approach, first reported by the Chinese University of Hong Kong, provides a new armamentarium to the laparoscopic Urologist.