Cystectomy - Revision history

Sglier1: added considerations for ileal conduit & neobladder creation

2025-10-03T16:19:40Z

added considerations for ileal conduit & neobladder creation

← Older revision		Revision as of 09:19, 3 October 2025
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	}}		}}

	A cystectomy is the removal of all or part of the urinary bladder. Most commonly, this procedure is performed to address cancer.		A cystectomy is the removal of all or part of the urinary bladder. Most commonly, this procedure is performed to address cancer. May be combined with prostatectomy, ileal conduit, or neobladder reconstruction.

	== Preoperative management ==		== Preoperative management ==
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	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

	* If radical cystectomy, have T&S and consider T&C 2 units		* If robotic, patient will be in steep Trendelenburg for a large portion of the case
			*If radical cystectomy, have T&S and consider T&C 2 units
	* Some centers use indocyanine 25mg to visualize blood flow to the ureters		* Some centers use indocyanine 25mg to visualize blood flow to the ureters
			*If construction of ileal conduit or neobladder, surgeons generally like to keep the patient dry to prevent diuresis and high UOP during the case; liberalize fluid goals after completion of anastamoses

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===

Oliviamsutton: updated bottom table, infobox

2022-04-05T00:26:25Z

updated bottom table, infobox

← Older revision		Revision as of 17:26, 4 April 2022
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	\| considerations_preoperative =		\| considerations_preoperative =
	\| considerations_intraoperative =		\| considerations_intraoperative =
	\| considerations_postoperative =		\| considerations_postoperative = hemorrhage, wound infection, DVT, UTI, ureterointestinal leakage, ileus
	}}		}}

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	\|-		\|-
	\|Unique considerations		\|Unique considerations
	\|		\|Involves removal of entire bladder, nearby lymph nodes, part of the urethra, and nearby organs that may contain cancer cells
	\|		\|Possible when the cancerous lesion is located in the dome of the bladder. Does not require urinary diversion
	\|		\|Simple, open cystectomy involves removal of the entire bladder without removal of any adjacent structures or organs. Urinary diversion is then created.
	\|		\|
	\|		\|
	\|-		\|-
	\|Position		\|Position
	\|		\|Supine, sometimes lithotomy for females
	\|		\|Supine
	\|		\|Supine, one or both arms out
	\|		\|
	\|Steep Trendelenburg		\|Steep Trendelenburg

Chris.Rishel: Text replacement - "|Respiratory" to "|Pulmonary"

2022-02-22T05:43:45Z

Text replacement - "|Respiratory" to "|Pulmonary"

← Older revision		Revision as of 22:43, 21 February 2022
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	\|		\|
	\|-		\|-
	\|~~Respiratory~~		\|Pulmonary
	\|		\|
	\|-		\|-

Tony.Wang at 01:44, 24 May 2021

2021-05-24T01:44:46Z

← Older revision		Revision as of 18:44, 23 May 2021
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	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
	[[Category:~~Urologic surgery~~]]		[[Category:Urology]]

Nkamdar: updated procedure variants and maintenance of anesthesia.

2021-05-10T18:06:49Z

updated procedure variants and maintenance of anesthesia.

← Older revision		Revision as of 11:06, 10 May 2021
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	=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===		=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===

			* 2 PIVs for open, radical, or robotic cystectomy (18g+)

	=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===		=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===

			* GETA

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
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	* If radical cystectomy, have T&S and consider T&C 2 units		* If radical cystectomy, have T&S and consider T&C 2 units
			* Some centers use indocyanine 25mg to visualize blood flow to the ureters

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
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	=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===		=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===

			* PACU

	=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===		=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===
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	!Open cystectomy		!Open cystectomy
	!Minimally invasive cystectomy		!Minimally invasive cystectomy
			!Robotic cystectomy
	\|-		\|-
	\|Unique considerations		\|Unique considerations
			\|
	\|		\|
	\|		\|
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	\|		\|
	\|		\|
			\|Steep Trendelenburg
	\|-		\|-
	\|Surgical time		\|Surgical time
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	\|		\|
	\|		\|
			\|~ 4-6 hrs
	\|-		\|-
	\|EBL		\|EBL
	\|300-1500		\|300-1500
	\|Minimal		\|Minimal
			\|1000mL
	\|		\|
	\|		\|100-200mL
	\|-		\|-
	\|Postoperative disposition		\|Postoperative disposition
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	\|		\|
	\|		\|
			\|PACU
	\|-		\|-
	\|Pain management		\|Pain management
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	\|		\|
	\|		\|
			\|2
	\|-		\|-
	\|Potential complications		\|Potential complications
			\|
	\|		\|
	\|		\|

Barrett.Larson at 18:45, 16 April 2021

2021-04-16T18:45:57Z

← Older revision		Revision as of 11:45, 16 April 2021
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	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
			[[Category:Urologic surgery]]

Barrett.Larson at 17:52, 16 April 2021

2021-04-16T17:52:37Z

← Older revision		Revision as of 10:52, 16 April 2021
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	}}		}}

	A cystectomy is the removal of all or part of the urinary bladder. Most commonly, this procedure is to address cancer.		A cystectomy is the removal of all or part of the urinary bladder. Most commonly, this procedure is performed to address cancer.

	== Preoperative management ==		== Preoperative management ==

Barrett.Larson at 17:51, 16 April 2021

2021-04-16T17:51:50Z

← Older revision		Revision as of 10:51, 16 April 2021
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	{{Infobox surgical case reference		{{Infobox surgical case reference
	\| anesthesia_type =		\| anesthesia_type = General / Neuraxial
	\| airway =		\| airway = ETT
	\| lines_access =		\| lines_access = Partial: PIV x 1 (20) <br/>
	\| monitors =		Radical: PIV x 2 (18 or 16)
			\| monitors = Partial: Standard <br/>
			Radical: Std + art line
	\| considerations_preoperative =		\| considerations_preoperative =
	\| considerations_intraoperative =		\| considerations_intraoperative =
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	=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===		=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===

			* If spinal used, ensure T4 sensory level
			** Consider using epi in spinal to prolong block
			* Can consider placing epidural if significant post-op pain anticipated

	== Intraoperative management ==		== Intraoperative management ==
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	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===

			* Supine
			* Sometimes females placed in lithotomy

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

			* If radical cystectomy, have T&S and consider T&C 2 units

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
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	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===

			* Bleeding

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==
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	\|+		\|+
	!		!
			!Radical cystectomy
	!Partial Cystectomy		!Partial Cystectomy
	!~~Radical Cystectomy~~		!Open cystectomy
			!Minimally invasive cystectomy
	\|-		\|-
	\|Unique considerations		\|Unique considerations
			\|
			\|
	\|		\|
	\|		\|
	\|-		\|-
	\|Position		\|Position
			\|
			\|
	\|		\|
	\|		\|
	\|-		\|-
	\|Surgical time		\|Surgical time
			\|4-6 hours
			\|~ 2 hours (urinary diversion not required)
	\|		\|
	\|		\|
	\|-		\|-
	\|EBL		\|EBL
			\|300-1500
			\|Minimal
	\|		\|
	\|		\|
	\|-		\|-
	\|Postoperative disposition		\|Postoperative disposition
			\|
			\|
	\|		\|
	\|		\|
	\|-		\|-
	\|Pain management		\|Pain management
			\|
			\|
	\|		\|
	\|		\|
	\|-		\|-
	\|Potential complications		\|Potential complications
			\|
			\|
	\|		\|
	\|		\|

Barrett.Larson: Created page with "{{Infobox surgical case reference | anesthesia_type = | airway = | lines_access = | monitors = | considerations_preoperative = | considerations_intraoperative = | consid..."

2021-04-16T17:34:29Z

Created page with "{{Infobox surgical case reference | anesthesia_type = | airway = | lines_access = | monitors = | considerations_preoperative = | considerations_intraoperative = | consid..."

New page

{{Infobox surgical case reference
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

A cystectomy is the removal of all or part of the urinary bladder. Most commonly, this procedure is to address cancer.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Respiratory
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable"
|+
!
!Partial Cystectomy
!Radical Cystectomy
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]