Bladder Cancer Surgery Melbourne
Robotic radical cystectomy is a major surgical procedure for the treatment of muscle-invasive bladder cancer or high-risk non-muscle invasive disease that has not responded to intravesical therapy. Using the da Vinci robotic system, the entire bladder is removed along with nearby lymph nodes and, in men, the prostate and seminal vesicles. In women, the uterus, ovaries, and part of the vagina may also be removed. A new way to store and drain urine (urinary diversion) is then created.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- Minimally invasive approach with smaller incisions
- Enhanced precision with 3D magnified visualisation
- Reduced blood loss compared to open surgery
- Faster recovery and shorter hospital stay
- Lower risk of wound complications
- Equivalent cancer outcomes to open surgery
The Procedure
The procedure is performed under general anaesthesia and typically takes 4-6 hours. Six small incisions are made in the abdomen for the robotic ports. The bladder and surrounding structures are carefully dissected and removed along with pelvic lymph nodes. A urinary diversion is then created - either an ileal conduit (a stoma on the abdomen that drains into a bag) or a neobladder (a new bladder created from intestine that allows voiding through the urethra). The choice of diversion depends on tumour location, patient factors, and preferences.
Who Is a Candidate?
Radical cystectomy is recommended for muscle-invasive bladder cancer (stage T2 or higher), high-grade T1 bladder cancer that recurs despite BCG therapy, carcinoma in situ (CIS) unresponsive to BCG, extensive multifocal non-muscle invasive disease, and some cases of intractable haemorrhage or non-functioning bladder. Neoadjuvant chemotherapy before surgery improves survival in eligible patients.
Recovery
Hospital stay is typically 7-10 days. An enhanced recovery protocol is used to optimise recovery. You will have a nasogastric tube, urinary catheter, and surgical drains initially. Bowel function typically returns within 3-5 days. Full recovery takes 8-12 weeks. If you have a neobladder, you will learn to void using abdominal pressure and may need to self-catheterise occasionally. If you have an ileal conduit, stoma nurses will teach you how to manage your stoma bag.
Risks & Considerations
As a major cancer operation, risks include bleeding and need for blood transfusion, bowel injury or leak, urine leak, wound infection, blood clots, ileus (temporary bowel paralysis), urinary tract infection, erectile dysfunction in men, and long-term risks such as ureteric stricture, metabolic changes from bowel segment use, hernia, and small bowel obstruction. The 90-day mortality rate is approximately 2-3% in high-volume centres.