[3] A radical cystectomy involves removal of the entire bladder along with surrounding lymph nodes and other nearby organs that contain cancer.

[4] Evaluation of the tissue removed during cystectomy and lymph node dissection aids in determining pathological cancer staging.

[7] A partial cystectomy may also be performed for removal of tumors which have originated and spread from neighboring organs such as the colon.

[4] In an open radical cystectomy a large incision is made in the middle of the abdomen from just above or next to the umbilicus to the pubic symphysis.

[9][10] A minimally invasive radical cystectomy more commonly known as a robot-assisted laparoscopic radical cystectomy (RARC) may be an option for individuals depending on several factors including but not limited to: their overall health (with special attention to their lung health), body mass index (BMI), number and types of previous surgeries, along with the location and size of the bladder cancer.

A head down (Trendelenburg) position is used and the abdomen is inflated with gas (insufflation) to allow better operating space and visualization.

[6][11] Compared to open surgery, minimally invasive radical cystectomy probably requires fewer blood transfusions and may shorten hospital stay slightly.

This includes individuals who cannot tolerate general anesthesia or those with severe or inadequately managed co-morbidities such as diabetes, heart, lung, kidney, or liver disease.

During this method of surgery the positioning and abdominal insufflation places extra strain on the chest wall impairing lung function and the ability to oxygenate the blood.

[6][16] A partial cystectomy is contraindicated in a form of bladder cancer called carcinoma in situ (CIS).

[9] Radical cystectomy with the creation of a urinary diversion can be associated with several risks and complications due to the extent and complexity of the surgery.

If this occurs, another procedure to insert a percutaneous nephrostomy tube may be need to allow drainage of urine from the body.

A small, hollow, flexible tube called a stent may be placed inside the ureter at the time of surgery to possibly help the reconnection site to heal.

[19][11] If a partial cystectomy is performed, damage to the ureter may occur depending on the location of the tumor removed.

[9] Due to the location of the operation, damage to nerves in the pelvis can occur during removal of the bladder or lymph nodes.

[11] For people who have difficulties eating before or after a radical cystectomy, additional nutrition may be beneficial when compared with waiting until ordinary food can be tolerated.