Dr James Thompson is an experienced robotic, laparoscopic, endoscopic and open urological surgeon. He has sub-specialty training in (and passion for) the treatment of prostate, bladder and kidney cancer using the latest robotic surgery techniques and for high-impact cancer research that has the ability to immediately improve quality of life and cancer cure rates for the community.
Why have robotic surgery for bladder cancer?
Robotic bladder surgery offers many benefits over old-fashioned open surgery, similar to those of robotic prostate surgery.
Major advantages include:
1) major reduction in average blood loss: Over 1-1.5 Litres for open vs less than 500mL for robotic surgery
2) major reduction in risk of blood transfusion: up to 30% for post chemo patients (who often have a Pre-op starting haemoglobin level of 100 or less) vs less than 10% for robotic
3) a massive reduction in wound infection, dehiscence (separation) and hernia from up to 10% with open surgery down to less than 1%
4) better vision and more precise dissection to allow increase preservation of nerves for sexual function in men and vaginal size for sexual function in women
5) better vision and precision for complex salvage surgery eg after radiation, brachytherapy, past radical prostatectomy or bowel cancer surgery , thus reducing the risk of uncommon but disastrous complications such as rectal injury resulting in a bowel stoma bag (colostomy)
6) less pain, shorter hospital stay and faster return to normal activities.
Why don’t all surgeons perform bladder surgery robotically then?
Sadly, almost all urologists (greater than 95%) are not trained to perform bladder cancer surgery via a robotic approach, because it requires lengthy training in the technique and a long learning curve of at least 50-100 cases.
Even those urologists who have trained as robotic prostate and kidney surgeons are mostly unable to perform robotic bladder removal surgery, because of the additional complexity of creating a new urine reservoir, i.e. a neobladder or ileal conduit.
Almost all urologists (more than 95%) only perform ‘a couple’ ie less than 5 bladder removal operations per year. This low number makes it impossible for them to invest the time and effort in learning robotic bladder surgery, which requires at least 50- 100 operations to achieve competence.
Some urologists ‘pretend’ to perform robotic bladder surgery, by removing the bladder and lymph nodes robotically, but then they make an unnecessary large surgical incision to create the urinary reservoir. This defeats many of the benefits in terms of pain/ wounds/ infections of true robotic surgery, in which the entire operation - including the urinary diversion - is performed internally via robotic surgery.
How many bladder removals has Dr Thompson performed, and how many does he perform per year?
Dr Thompson has performed greater than 250 open and robotic bladder removals during his urology training, UK fellowship, UK consultant tenure and Australian consultant tenure.
He has performed over 100 purely robotic bladder surgeries and currently performs around 20 robotic and open bladder removal surgeries per year, making him one of the most experienced and highest volume robotic bladder surgeons in Australasia.
He is also one of the few urologists in Australia to perform robotic and open neo-bladder surgery, nerve sparing cystectomy, vaginal sparing cystectomy, salvage surgery post radiation or brachytherapy, robotic partial cystectomy and diverticulectomy.