Female Cystectomy and Urinary Diversion
The aim of robotic-assisted Cystectomy is to remove your bladder, uterus, ovaries, part of your vagina and local lymph glands to give the best chance of removing all the cancer. This is done by using very small, robotic instruments that allow precise surgery through tiny keyhole incisions in your abdomen.
A robotic-assisted Cystectomy usually involves the removal of your bladder, uterus, ovaries, part of your vagina and local lymph glands to give the best chance of removing all the cancer. The ureters (the tubes that drain from the kidneys to the bladder) are attached to a piece of resected small bowel and this is brought to the surface, through the chosen stoma site.
The small bowel from which the stoma was resected is then reattached to itself. A drain where the bladder has been removed and leave two smalls splints in the ureters, protruding from the end of your urostomy and a drainage bag is attached.
This procedure can take anything from 2-6 hours to perform, depending on the complexity of the surgery. You should expect to be in hospital for 7-14 days.
Your Specialist will review your medical history and discuss the surgery with you to confirm your consent.
A Stoma Specialist Nurse will help you decide on the ideal site for your stoma. They will mark this area on your abdomen. It’s important this isn’t washed off as the specialist will need to reference the site during surgery.
An anaesthetist will discuss your options of anaesthetic, whether that be general or spinal. They will also discuss your pain relief plan for your post-operative recovery.
You may be provided with a pair of TED stockings to wear and you may be given a heparin injection to thin your blood. These help prevent blood clots, your medical team will decide whether you need to continue with these post-surgery.
We will encourage you to get up and about as soon as possible. This reduces the risk of blood clots in your legs and helps your bowel to start working again. You will sit out in a chair shortly after the procedure and shown deep breathing and leg exercises. We will also encourage you to start drinking and eating as soon as possible.
We will remove your drains once they have stopped draining. The splints in your stoma will be removed 10-14 days after your procedure.
You will be given advice on your recovery at home and a copy of your discharge summary will be given to you as well as being sent to your GP. You will be provided with a prescription for any antibiotics or medication which can be filled by your local pharmacy.
By the time you get home, you should be able to perform “daily living” activities such as making a cup of tea, preparing food and emptying your stoma bag. You will feel tired for several weeks and may need to take regular “cat naps” during your day.
We will arrange for the stitches or clips in your wound to be removed after 10-12 days.
If you get a fever or start vomiting, especially if associated with unexpected pain in your abdomen, you should contact your GP immediately.
A follow up appointment will be made for you 6-12 weeks after your surgery.
