Robotic Cystectomy

Surgery for muscle-invasive bladder cancer is a complex procedure with multiple steps that include bladder removal, lymph node dissection, and urinary diversion.

This can be performed as an open procedure or with the da Vinci Xi robotic surgical platform. At Sydney Urology Group, Dr Scott Leslie performs all aspects of the surgery minimally invasively utilising the da Vinci Xi robot.

Dr Leslie undertook a fellowship in robotic surgery at the University of Southern California (USC) in Los Angeles. During this time, the USC urology department, led by Dr Inderbir Gill, pioneered robotic surgery for bladder cancer and Dr Leslie has since proctored urologists in Sydney and throughout Australia with this complex procedure.

The benefits of the robotic approach over open surgery for bladder cancer remains controversial, however recent randomised controlled trials have demonstrated equivalent oncological outcomes between the two techniques.

To study this further, Dr Leslie is the principal investigator for a randomised controlled trial assessing the peri-operative outcomes of open versus robotic urinary diversion following cystectomy (UDIVERT study).

For female patients undergoing cystectomy for bladder cancer, it may be possible to preserve the surrounding gynaecological organs including the vagina, uterus and ovaries. This is particularly relevant for younger patients whom are sexually active, however necessitates that the tumour is away from these organs and magnetic resonance imaging is an important preoperative test to help with surgical planning.

Similarly, in men that are interested in preserving sexual function, a nerve-sparing cystectomy procedure can be performed as long as the neurovascular bundles are remote from cancer.

This is a highly specialised team performing radical pelvic surgery for locally advanced cancers that require removal of multiple organs (typically the colon and bladder) followed by urinary diversion. This major surgery can be life-saving however it can take some time for patients to recover. For select patients this surgery can now be performed robotically, and a phase 1 study is now underway at RPAH to assess the safety, feasibility and potential benefits of faster recovery for this novel robotic technique.

At Sydney Urology Group the surgeons appreciate the complexity of bladder cancer surgery, and the recovery following this procedure is typically more prolonged compared to other urological cancer operations, even when minimally invasive robotic techniques are utilised. The nurses and doctors who are integral to Sydney Urology Group offer guidance throughout our patient’s bladder cancer journey. From diagnosis, to pre-treatment optimisation, to radical cystectomy and beyond, the team at Sydney Urology Group are available to provide support and to help optimise recovery.

At Sydney Urology Group we are able to offer robotic bladder cancer surgery for both private and public patients.

Dr Leslie performs robotic surgery for his private patients at Chris O’Brien Lifehouse and The Mater Hospital.

Dr Leslie is privileged to work in the public hospital system and is able to offer robotic bladder cancer surgery at Royal Prince Alfred hospital.