UROLOGIC OPERATION 7 cystectomy

Cystectomy

Objective

In cases of cancer of the bladder

•   Removal of the urinary bladder in part or whole.

Position

Supine.

Anesthesia

Procedure

   1.  A cystoscopy is performed.

   2.  A midline or low transverse incision is made.

   3.  The operative field explored.

   4.  The bladder is dissected from its vascular supply.

   5.  The prostate and seminal vesicles are included in the specimen.

   6.  The distal ureters, urethra, and vas are divided and ligated.

   7.  Urinary diversion.

   8.  A closed-system wound drain may be employed.

   9.  Wound drain may be employed.

10.  Wound is closed in layers.

Instruments

•   General set

•   Deep instruments set

•   Kidney procedures set

•   Gastrointestinal procedures set (Available)

•   Abdominal hysterectomy set (Available)

•   Self-retaining retractor (e.g. Balfour, O’Connor O’Sullivan) (Fig. 8.87)

•   Hemoclip appliers (assorted sizes and lengths) (Fig. 11.11)

•   Drain (e.g., Hemovac, Jackson-Pratt, Penrose).

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