Completely Laparoscopic, Robotic Bladder Surgery is Region's First

September 23, 2016

Dragan Golijanin, M.D.

The Minimally Invasive Urology Institute (MIUI) at The Miriam Hospital is now performing a completely laparoscopic surgery for the treatment of bladder cancer.

The procedure – robot-assisted laparoscopic radical cystectomy with intracorporeal urinary diversion – can be used to remove the bladder, pelvic lymph nodes and prostate in men, and the bladder, uterus and fallopian tubes in women. The surgery concludes with removing a piece of bowel and using it to create a urinary diversion, or way for urine to leave the body in the absence of the bladder. The entire surgery is performed with an intracorporeal approach, meaning completely laparoscopically within the body, versus traditional open surgery.

Previously, the surgery was performed at The Miriam Hospital with a seven- to 10-centimeter incision at the belly button, and the urinary diversion was created through this incision, outside the body. Most other institutions still perform the surgery with a large incision in an open surgical approach. In addition to featuring smaller incisions, the minimally invasive intracorporeal approach offers improved patient outcomes, including a lower complication rate and shorter hospital stay, according to the International Robotic Cystectomy Consortium.  

Dragan Golijanin, MD, director of genitourinary oncology at The Miriam and Rhode Island hospitals and co-director of the MIUI, is among the first 11 urologists nationwide, and the only physician in New England, to have successfully performed a robotic cystectomy with intracorporeal urinary diversion. The first hospital in Southern New England to perform a robot-assisted procedure, The Miriam has completed more than 2,000 urologic robot-assisted surgeries since 2006.

“In being able to perform this difficult surgery laparoscopically from beginning to end, we are able to remain on the leading edge of bladder cancer treatments by offering patients the latest, most innovative care available. The result is improved outcomes for our patients. This further demonstrates our commitment to advanced urologic treatments,” said Golijanin.

Cancer of the urinary bladder is the fifth most common cancer in Rhode Island, and the sixth most common in the United States. Bladder cancer also has the highest recurrence rate of any form of cancer. The most common symptom is blood in the urine, and a patient who experiences this should contact his or her physician immediately. Other symptoms include frequency, urgency, or pain while urinating.

Elena Falcone-Relvas

Bradley Hospital & Hasbro Children's Hospital