Cystectomy Health Article

Partial cystectomy

During partial or segmental cystectomy, only the area of the bladder where the cancer is found is removed. This allows for most of the bladder to be preserved. Because the cancer must not have spread to the bladder muscle and must be isolated to one area, partial cystectomy is only used infrequently for the patients who meet these select criteria.

The patient is first placed under general anesthesia. After an incision is made into the lower abdomen, the bladder is identified and isolated. The surgeon may choose to perform the operation with the bladder remaining inside the abdominal cavity (transperitoneal approach) or with the bladder lifted outside of the abdominal cavity (extraperitoneal approach). The cancerous area is excised (cut out) with a 0.8 in (2 cm) margin to ensure that all abnormal cells are removed. The bladder is then closed with stitches. The pelvic lymph nodes may also be removed during the procedure. After the cancerous tissue is removed, it is examined by a pathologist to determine if the margins of the tissue are clear of abnormal cells.

Simple or radical cystectomy

While partial cystectomy is considered a bladder-conserving surgery, simple and radical cystectomy involves the removal of the entire bladder. In the case of radical cystectomy, other pelvic organs and structures are also removed because of the tendency of bladder cancer to spread to nearby tissues. After the patient is placed under general anesthesia, an incision is made into the lower abdomen. Blood vessels leading to and from the bladder are ligated (tied off), and the bladder is divided from the urethra, ureters, and other tissues holding it in place. The bladder may then be removed.

The surgical procedure for radical cystectomy differs between male and female patients. In men, the prostate, seminal vesicles, and pelvic lymph nodes are removed with the bladder. In women, the uterus, fallopian tubes, ovaries, anterior (front) part of the vagina, and pelvic lymph nodes are removed with the bladder. If the surgery is being performed as a treatment for cancer, the removed tissues may be examined for the presence of abnormal cells.