The procedure is performed under general anesthesia, and can take upto 3 to 4 hours.
For open surgery, the surgeon will make a long incision in the lower abdomen area to access the bladder and lymph nodes.
For laparoscopic surgery, several small incisions are made in the lower belly. A laparoscope containing camera is inserted from one of the cuts, and surgical tools are inserted from other incisions.
The surgeon has to create a passage for the urine to pass out of the body. This can be done using
- Urinary Conduit: A part of small intestine is used to make an ileal conduit or a tube. Ureters that drain urine from kidney are attached to the abdominal wall using this tube. In the abdomen, an opening in the skin allows the patient to drain the urine.
- Continent Urinary Diversion: In this method, a small reservoir is created in the abdominal wall. The ileal conduit drain urine in this reservoid. Using a catheter, the urine is drained periodically.
- Neobladder: This technique is used only when the urethra is not removed. In this method, a part of the bowel is folded to make a pouch that carries the urine. This is attached to the ureters from the kidney. This procedure allows the patient to urinate in a normal way.