Surgery

Urologic and Prostate Cancer Surgery

Nearly all of our prostate cancer surgeries and many of our kidney cancer surgeries are minimally invasive, leading to shorter hospital stays, faster recovery times, and less complications for our patients. For the surgical treatment of bladder and testicular cancer, we make every effort to preserve your urinary and sexual function while successfully removing the cancer.

John Muir Health was one of the first medical centers in California to offer robotic prostatectomies.

Prostate Cancer Surgical Option

Robotic Laparoscopic Radical Prostatectomy – John Muir Health is one of a few Bay Area medical institutions to offer this innovative minimally invasive surgical technique that improves the surgical outcome.

The surgeon removes all of the prostate gland through miniature incisions using the daVinci™ Surgical System, whose 3D high-definition magnification and robotic arms give the surgeon a very clear view of the surgical area and a better ability to manipulate the surgical instruments.

Kidney Cancer Surgical Options

Robotic Laparoscopic Partial Nephrectomy – Used for treating patients with early stage kidney cancer, this innovative procedure often allows us to save at least part of the patient’s kidney while successfully removing the cancer. In the past, even the excision of the smallest tumor required the removal of the entire kidney. This procedure, which is another one in which John Muir Health specializes, uses the same daVinci™ Surgical System that we use for the Robotic Laparoscopic Radical Prostatectomy.

Laparoscopic Nephrectomy – If the kidney cancer is in its advanced stages or has metastasized (spread) to other parts of the body, we often need to remove the entire kidney. However, we can still use the minimally invasive laparoscopic approach in which we use a camera-equipped scope and surgical instruments inserted through very small incisions, leading to a faster recovery time and fewer complications. If the cancer has metastasized, we often combine surgery with biologic agents to prevent the cancer from growing.

Bladder Cancer Surgical Options

Cystoscopy/Transurethral Resection – For superficial bladder cancer, this minimally invasive procedure uses the same camera-equipped cytoscope for treatment that is used for diagnosing. The cancer is treated via surgical instruments inserted through the cytoscope, or an electric probe that burns away the cancer. Following surgery, some patients may undergo a regimen of chemotherapy or biologic therapy.

Urinary Diversion Surgeries – For several patients who undergo bladder cancer surgery, John Muir Health offers two very advanced procedures for creating a replacement bladder, which allows patients to urinate without having to use an external collection bag.

Orthotopic Neobladder If your urethra is spared during surgery, we may be able to fashion a replacement bladder sourcing the tissue from your intestine without affecting your bowel functions, then connecting the new (“neo”) bladder to your urethra, enabling you to urinate naturally.

Continent Cutaneous Diversion – If your urethra needs to be removed, this procedure allows you to store urine in a reservoir connected to the abdomen with a stoma, which is essentially an outlet. The patient empties the reservoir about five times a day by connecting a catheter or plastic tube to the stoma.

Testicular Cancer Surgical Options

Orchiectomy – For the treatment of testicular cancer, the surgeon removes the affected testicle and spermatic cord through the groin area rather than the scrotum to reduce the risk of spreading cancer through the scrotum’s loose skin. While surgery is always necessary for the treatment of testicular cancer, the unaffected testicle is not removed because the risk of cancer development is very low. This will leave you with adequate levels of male hormones and preserve your fertility.

Retroperitoneal Lymph Node Dissection (RPLND) – If the testicular cancer has spread to lymph nodes, we use this procedure to remove them in the pelvis and lower abdomen. John Muir Health offers a nerve-sparing technique to help preserve ejaculatory function by sparing the associated nerve bundles during lymph node removal if the cancer has not spread too deep. A longer, more complex procedure than orchiectomy, RPLND is typically done at a later date.

Learn how we treat urologic and prostate cancer with radiation oncology