Robot-Assisted Laparoscopic High-Intensity Focused Ultrasound and Radical Cystectomy for Thermal Ablation of Muscle Invasive Cells in Patients With Bladder Tumors

Inclusion Criteria: * Must meet all inclusion and exclusion criteria * Presence of a muscle invasive bladder tumor(s) (T2), specific for transitional cell carcinoma on pre-operative histology (i.e. biopsy or transurethral resection of bladder tumor \[TURBT\]). * Presence of a single bladder tumor lesion * Patients are scheduled to undergo RARC at our institution * Subjects must have given written informed consent to agree to participate * Previous chemotherapy, and/or biological therapy for cancer are permitted provided that the acoustic properties of the tumor were not affected, but the subject should have recovered from the effects of these or of any prior surgery; chemotherapy can be within 70 days of operation * Subjects must be free of any clinically significant disease other than cancer that would interfere with the study evaluations * Pre-operative computed tomography (CT)/magnetic resonance imaging (MRI) abdomen and pelvis within 90 days * Absolute neutrophil count (ANC) \>= 1500 mm\^-3 * Platelet count \>= 100,000 mm\^-3 * Hemoglobin \>= 10 g/dl * Prothrombin time (PT) =\< 1.5 times upper limit of laboratory normal (ULN) * Activated partial thromboplastin time =\< 1.5 times ULN * Total bilirubin \< 1.5 times ULN * Aspartate aminotransferase (AST) =\< 3 times ULN * Alkaline phosphatase \< 2 times ULN, unless arising from bone Exclusion Criteria: * Subjects deemed unsuitable candidates and not medically optimized for RARC * Subjects with tumors lying \< 1 cm from se…