img
>Dr. H. S. Bhatyal

Dr. H. S. Bhatyal
Advisor & Sr. Consultant
Urology, Andrology & Renal
Transplant,
BLK Super Speciality
Hospital, New Delhi

Need of the Hour

Neobladder Procedure: Defeating Cancer with
Innovative Surgical Interventions

THE CASE

A 50-year old man from Delhi, diagnosed with life-threatening Urinary Bladder Cancer, was brought to BLK Super Speciality Hospital. The patient’s health was deteriorating alarmingly. However, his strong will and timely medical intervention and advanced procedures at BLK Super Speciality gave him a new lease on life.

THE PROCEDURE

On admission, Dr. H. S. Bhatyal recommended a Radical Cystectomy and Orthotropic Neobladder, one of the most advanced treatments for Cancer. The medical team, headed by Dr. Bhatyal, performed the procedure on the patient taking great care to successfully mitigate the operating risks and post-treatment trauma that comes with the procedure.

The creation of Neobladder and joining it to native urethra without tension is a challenging step. To minimise complications, Dr. Bhatyal introduced a noble modification of the technique by iso-peristaltic part of the efferent loop of ileum (about 1cm) and enhancing the length of this segment by about 2cm by using the adjacent detubularised ileal segment to achieve tension-free anastomosis and to guarantee adequate urinary continence.

THE RESULT

The surgery was performed uneventfully. Post-surgery, the Cystogram results substantiated the recovery as the bladder has regained its original healthy shape with insignificant urine residue. Two months after the surgery, the patient completely recovered and is doing well with excellent urinary function.

DISCUSSION

Radical Cystectomy with extended Lymphadenectomy and urinary diversion is considered as the ‘Gold Standard’ treatment for Bladder Cancer. Urinary diversion is made either in the form of an ideal conduit, continent urinary reservoir or Orthotropic Neobladder. Out of these, Orthotropic Neobladder reconstruction has become an increasingly common urinary diversion following Cystectomy for Bladder Cancer. However, the alarming rise of Cancer cases urgently calls for noble solutions, like the one by Dr. Bhatyal, to break the barriers of cost and to make available sustainable and easily implementable solutions.