Overview
Bladder cancer is one of the most common cancers in men and women, with about 75,000 new cases diagnosed in the United States each year. In New Jersey, about 2,500 new cases are detected annually. Fortunately, most patients - about 70 percent - develop a non-muscle-invasive or superficial type and can be treated by removing the tumor while keeping the bladder intact.
The remaining 30 percent of patients, however, need to have the entire bladder removed, a surgical procedure called a cystectomy. The majority of these patients with invasive bladder cancer - about 80 percent - will have a surgical procedure that either requires a bag located outside the body to collect urine or a pouch inside the abdomen that needs to be emptied several times a day with a catheter. But new strides in bladder cancer treatment now give patients an option that allows them to urinate normally.
A neobladder, a reconstructed pouch made from the small intestine, can be connected to the ureters and urethra within the body. A select number of urologic oncologists across the country, including Dr. Raul Parra, Medical Director of the Regional Cancer Center at Holy Name Medical Center, perform this complex procedure that avoids the need for a bag outside the body or the need for catheterizations multiple times a day and greatly improves the quality of the patient's life. Dr. Parra further enhances the patient's recovery by performing the surgery robotically.
Dr. Parra, who pioneered the first laparoscopic bladder removal in 1991, is one of only three surgeons in the New Jersey/New York area who performs robotic removal and reconstruction of the bladder. It is a vast improvement over the current open surgery standard, which was first done in the 1980s and has not evolved much. Most physicians decline to create a new bladder because of the difficulty of the surgery and the challenges in post-op care. It sometimes results in patients needing up to two weeks in the hospital for recovery. When it is performed, it is typically done only in highly specialized medical centers.
Now Holy Name, which specializes in more personal care than many larger facilities, offers robotic cystectomies and bladder reconstruction closer to home. Dr. Parra's experience with this leading-edge cancer treatment allows patients a quicker recovery with less pain, a smaller incision - the procedure is done through five small openings - and a reduced risk of infection.
Not all patients are good candidates for the robotic procedure. The elderly or morbidly obese may not be eligible for the reconstruction. Dr. Parra also performs cystectomies and reconstruction via open surgery.
