After ordeal, Las Vegas man has robotically rebuilt bladder

Charlie Metzger’s surgery to give him a new urinary bladder played out like an anti-smoking public service announcement.

After his recovery, the four keyhole incisions created during the first case of robotically rebuilt bladder in Las Vegas belie the extent nightmare he has endured.

Video produced by the da Vinci Si robotic surgery system during the seven-hour ordeal would be a powerful tool to encourage smokers to quit. Metzger, 47, said the experience has given him the motivation to kick the habit for good.

“I’m done,” he said earlier this month from his bed in a recovery unit at Sunrise Hospital.

Dr. Jayram Krishnan, a Las Vegas urologic surgeon, removed the bladder, and part of Metzger’s small intestine was used to create a so-called neobladder to enable Metzger to have a relatively normal urination pattern after he recovers.

In late April, Krishnan performed the procedure through the keyhole incisions instead of the open wound required with traditional bladder reconstruction surgery.

“This has always been done in the open with a big cut right down the center of the belly,” Krishnan said.

The single most important known risk factor for bladder cancer is smoking tobacco, according to the National Institutes for Health. Cigarettes produce toxins that enter the body when smokers inhale and are excreted through urine. The bladder can hold the urine for hours, exposing the lining to carcinogens. Smokers get bladder cancer at twice the rate of nonsmokers, but the risk gradually diminishes after people kick the habit.

The American Cancer Society estimates 74,000 new cases of bladder cancer and 16,000 deaths this year.

Cancer often requires removal of the entire bladder, but less advanced cases can be treated with chemotherapy, radiation, surgery to remove just the tumor or other steps to ensure the cancer has been destroyed.

Metzger, a truck driver for Western Elite and longtime resident of Southern Nevada, started noticing traces of blood in his urine in November, but he was in the middle of moving.

“We had just bought a house, so I just chalked it up to strenuous work,” he said. “There wasn’t any pain.”

After he was eventually diagnosed in December, he underwent chemotherapy and radiation treatments before his surgery April 28.

Metzger said last week that his recovery is ahead of schedule, but he continues to fight urges to smoke despite the greatest of all reasons to quit.

“It shouldn’t be that hard for me,” he said. “All I have to do is pick up my shirt and look at my belly.”

Contact Steven Moore at smoore@reviewjournal.com or 702-380-4563.