A serious operation, performed by a surgeon who has been doing it since the technique began.
Radical cystectomy removes the bladder and reconstructs urinary drainage. It is one of the most demanding operations in urology. Robotic cystectomy reduces blood loss and shortens hospital stay compared to open surgery in selected patients, with equivalent cancer outcomes in published data. The first robotic cystectomy in New Jersey was performed by Dr. Savatta in November 2005. The first neobladder reconstruction in New Jersey followed in 2007.
Why cystectomy may be necessary
Muscle-invasive bladder cancer, certain high-risk non-muscle-invasive cases that fail intravesical therapy, and rarely benign conditions can require bladder removal. The decision is made carefully and rarely without prior treatment attempts.
Reconstruction options after cystectomy
Ileal conduit — a segment of small intestine carries urine to a stoma on the abdominal wall, drained into an external bag. The most common, the simplest to manage, and a reasonable choice for many patients.
Orthotopic neobladder — a new bladder constructed from intestine and connected to the urethra so the patient urinates more naturally. Selection criteria matter and not every patient qualifies.
Continent cutaneous reservoir — an internal pouch drained on schedule through a small abdominal stoma using a catheter. A middle option for patients who are not neobladder candidates but want to avoid an external appliance.
Recovery and follow-up
Hospital stay typically four to seven days, with structured rehabilitation. Long-term follow-up monitors cancer surveillance and the function of the urinary diversion.
Common questions
Robotic or open — does it matter?
In experienced hands, robotic and open cystectomy produce equivalent cancer outcomes. Robotic typically reduces blood loss and shortens stay for selected patients. Surgical experience matters more than the platform.