Walking within a day: How robotic surgery helped a 72-year-old beat aggressive bladder cancer

For 72-year-old Rajeev (name changed), what began as persistent urinary problems and repeated episodes of blood in the urine eventually led to the diagnosis of bladder cancer.

Tests revealed a large tumour in his urinary bladder. Further testing confirmed an aggressive form of bladder cancer that had spread across the bladder lining.

He was initially treated with immunotherapy delivered directly into the bladder, a standard treatment used to reduce the risk of cancer progression. However, the cancer did not respond well. The bleeding returned, and multiple tumours reappeared in different parts of the bladder, making surgery the next necessary step.

The case was particularly challenging because the patient was living with diabetes and high blood pressure, had previouslyundergone heart bypass surgery and was taking blood-thinning medicines. He also had 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 carried out through small keyhole incisions rather than a large abdominal cut, which was particularly important because of his skin condition.

Despite the complexity of the surgery and his multiple health conditions, Mr Rajeev 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.

The final laboratory examination of the removed tissue showed that the cancer had been successfully removed, with no signs of spread to the lymph nodes that were 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- Oncology Network, 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, 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"