Dr. H. S. Bhatyal
Advisor & Sr. Consultant
Urology, Andrology & Renal
BLK Super Speciality
Hospital, New Delhi
Need of the Hour
Neobladder Procedure: Defeating Cancer with
Innovative Surgical Interventions
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.
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
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 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.
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.