A 72-year-old patient, identified as Rajeev (name changed), initially experienced persistent urinary issues and repeated blood in the urine, which eventually led to a diagnosis of bladder cancer. Medical investigations revealed a large tumor in the urinary bladder, and further tests confirmed an aggressive form of the disease that had spread across the bladder lining.
He was first treated with immunotherapy administered directly into the bladder, a standard approach aimed at reducing the risk of cancer progression. However, the cancer did not respond favorably. The bleeding recurred, and multiple tumors reappeared in different parts of the bladder, making surgery the next necessary step.
The case was particularly challenging because the patient had diabetes and high blood pressure, had previously undergone heart bypass surgery, and was taking blood-thinning medications. He also suffered from severe psoriasis, a chronic skin condition with lesions affecting several parts of his body, including the abdomen.
Considering these factors, doctors opted for robotic surgery. Using the da Vinci Xi robotic system, they removed the cancer-affected bladder along with nearby tissues and lymph nodes. They then created a new pathway for urine using a small segment of the intestine. The entire procedure was performed through small keyhole incisions rather than a large abdominal cut, which was especially important due to his skin condition.
Despite the complexity of the surgery and his multiple health conditions, the patient recovered well. He was able to walk the day after surgery, regained bowel function on the second day, climbed stairs on the third day, and was discharged from the hospital on the fourth day.
Final laboratory examination of the removed tissue confirmed that the cancer had been successfully removed, with no signs of spread to the lymph nodes taken out during surgery. The case highlights how robotic surgery can help manage complex cancer cases while supporting faster recovery through a minimally invasive approach.
Dr. Harit Chaturvedi, Chief Executive Officer and Clinical Head of the Oncology Network at Indraprastha Apollo Hospital, Delhi, said, "With an ageing population, we are increasingly seeing cancer patients who also have multiple chronic health conditions. Managing such patients requires close coordination between different specialties so that treatment decisions are tailored to the individual rather than the disease alone."
Dr. Harshit Garg, Senior Consultant, Uro-Oncologist and Robotic Surgeon at Apollo Hospitals, Delhi, explained, "Advances in robotic surgery are allowing us to offer complex cancer procedures to patients who may previously have been considered high-risk for major surgery. The focus today is not only on treating the cancer effectively but also on helping patients recover and regain independence as early as possible."
