Minimally Invasive Surgery for Bladder Cancer

Bladder cancer is the sixth most common cancer in the United States and has been occurring more frequently over the past several decades. Survival rates are improving with new minimally invasive treatment options available. The most common type of bladder cancer is transitional cell carcinoma, which can also affect the kidneys and ureters. At Mount Sinai Urology, we are leading experts in treating bladder cancer with these minimally invasive procedures.

Endoscopy procedures for bladder cancer do not involve cutting into the body and are appropriate for tumors that are confined to the bladder lining (superficial bladder cancer). We can perform a transurethral resection of a bladder tumor (TURBT) by removing a bladder tumor through a resectoscope (telescope with an electrified wire loop attached). We insert this scope into the bladder via the urethra and cut out the bladder tumor. Then we send the tissue to a pathologist to determine the grade and stage of the tumor. We consider TURBT to be a first line treatment for bladder cancer when it is confined to the lining of the bladder.

Laparoscopic cystectomy and partial cystectomy is a minimally invasive approach to bladder cancer. The standard approach for people with muscle-invasive bladder cancer is to remove the entire bladder (radical cystectomy). In men, we remove the prostate along with the bladder; in women, we remove the urethra, uterus, fallopian tubes, ovaries, and anterior vaginal wall. In some cases, we can remove a tumor while preserving healthy tissue and bladder function using a nerve-sparing surgery and a combined modality approach.

Robotic cystectomies and partial cystectomies are among the most challenging surgeries to perform robotically. Reza Mehrazin, MD, is one of a handful of urologists in the New York area who performs robotic cystectomy and urinary diversion (creating a new method for urine to exit the body following bladder removal). As with other minimally invasive procedures, robotic surgery offers less blood loss, a shorter hospital stay, and quicker recovery for most patients.

Laser procedures can also help us remove a bladder tumor. We use a cystoscope (telescope that allows for a laser fiber attachment) and insert it into the urethra to vaporize the bladder tumor.