Tokuda Hospital Sofia

 БГ EN  РУ

Minimally Invasive and Laparoscopic Procedures

Minimally Invasive and Laparoscopic Department Benefits:

Annually, we diagnose and treat approximately 650 patients with excellent clinical outcomes and excellent patient service ratings. 

Our department is committed to deliver minimally invasive surgical interventions, which have been designed to minimize postoperative pain and discomfort, and reduce recovery times compared to conventional surgical techniques. Also our procedures allow the required time for administrating stomach tubes, urethral catheters, and abdominal drains to be significantly reduced. Additionally, the operated upon passages recover quicker therefore patients are able to drink fluid earlier allowing IV systems to be removed earlier. 

In regards to recovery, minimally invasive procedures are less traumatic to the body therefore patients are able to be mobile immediately after their procedure and one can expect full recovery and free movement quicker than compared to conventional surgeries. On average, people experience full recovery and return to a normal way of life within 1-2 weeks for standard interventions and 3-4 weeks for more complex interventions. 

Furthermore, post procedural scars are minimized because only small incisions are needed to insert laparoscopic instruments compared to the large incisions needed for conventional or open surgeries.  

In regards postoperative complications and risks early and late postoperative complication rates are low (below 3%), and the proportion of serious complications are even more rare.

Being ready to travel back home and/or plan to continue traveling after your procedure is easier, because of the reduced post procedural recovery times, low risk rates, and the predictable clinical outcomes of our minimally invasive procedures.

Additionally, we offer the option for a companion to stay with the patient in their hospital room during the recovery process.

 

Featured Services:  

Our minimally invasive and laparascopic department offers the following procedures
 with either laparoscopic or conventional surgical access techniques:

  1. Laparoscopic esophagus and stomach operations:
    1. Achalasia- cardia obstruction
    2. Esophageal diverticula and tumors
    3. Stomach polyps and tumors
    4. Stomach and duodenum ulcers and their complications such as bleeding and pyloric stenosis and duodenal stenosis
    5. Duodenal diverticula
  2. Laparoscopic surgery for gastroesophageal reflux disease, diaphragmatic hernias, and hiatal hernias
  3. Laparoscopic surgery for intestinal diseases:
    1.  Large intestinal and rectal tumors and polyps
    2.  Large and small intestinal diverticula and their complications- inflammation, bleeding, abscesses, and fistulas
    3. Crohn's disease affecting the large and small intestines
  4. Laparoscopic surgery for gall bladder and bile duct diseases including stones and bile duct blockages
  5. Laparoscopic surgery for acute and chronic appendicitis and appendix tumors 
  6. Laparoscopic surgery for diseases affecting the ovaries, fallopian tubes, and uterus: cystectomy, salpingectomy, myomectomy and adhesion correction due to previous  surgeries or pelvic inflammation.
  7. Specialized laparoscopic surgeries for overweight patients including bariatric and endocrine procedures
  8. Operations for liver diseases including liver cysts, echinococcus cysts, and tumors.
  9. Laparoscopic surgery for spleen diseases of the spleen including cysts, lymphomas, thrombocytopenias
  10. Specialized laparoscopic procedures for adhesion disease, acute and chronic intestinal obstruction or intestinal twisting.  
  11. Laparoscopic abdominal wall hernia operations including:
    1. inguinal and femoral hernias
    2. Spiegel hernias
    3. Umbilical hernias
    4. Epigastric hernias
    5. Post operative hernias
    6. Primary and recurrent hernias
    7. Unilateral or bilateral hernias
  12. Proctology contemporary diagnosis and treatment of anal rectal diseases including:
    1. Anal fissures
    2. Perianal abscesses and fistulas
    3. Internal and external hemorrhoids
    4. Rectal prolapse
    5. Anal strictures

 



Table 1: Medical Procedure, Hospital Treatment Period, Estimated Implant and Consumable Costs

Operation

Operation Duration

Hospital Treatment Period and Hospital Stay

Room Options Per Day

Implants and Medical Consumables* 

Medical Service Package Price

Estimated Total**

1. Laparoscopic esophagus and stomach operations

2-4 hours

6-8 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN) per night

1,030 EURO
(2,000 BGN)

3,070 EURO
(6,000 BGN)

4,700 EURO

2. Laparoscopic surgery for gastroesophageal reflux disease, diaphragmatic hernias, and hiatal hernias

2-3 hours

5-6 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

1,030 EURO
(2,000 BGN)

3,070 EURO
(6,000 BGN)

4,700 EURO

3. Laparoscopic surgery for intestinal diseases

3-5 hours

6-10 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

1,030 -2050 EURO
(2,000-4,000 BGN)

4,100 EURO (8,000 BGN)

6,800 EURO

4. Laparoscopic surgery for gall bladder and bile duct diseases including stones and bile duct blockages

1-2 hours

3-5 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

520 EURO
(1, 000  BGN)

2,050 EURO
(4,000 BGN)

2,900 EURO

5. Laparoscopic surgery for acute and chronic appendicitis and appendix tumors

1 hour

3-4 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

520 EURO
(1,000  BGN)

1,540 EURO (3,000 BGN)

2,400 EURO

6. Laparoscopic surgery for diseases affecting the ovaries, fallopian tubes, and uterus: cystectomy, salpingectomy, myomectomy and adhesion correction due to previous  surgeries or pelvic inflammation

1-2 hours

3-5 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

520 EURO
(1,000  BGN)

2,050 EURO (4,000 BGN)

2,900 EURO

7. Specialized laparoscopic surgeries for overweight patients  including bariatric and endocrine procedures

2-4 hours

5-10 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

3,070 EURO
(6,000 BGN)

6, 140 EURO (12,000 BGN)

9,900 EURO

8. Operations for liver diseases including liver cysts, echinococcus cysts, and tumors

3-5 hours

6-10 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

520-1030 EURO
(1,000-2 000 BGN)

4,100 EURO
(8,000 BGN)

5,800 EURO

9. Laparoscopic surgery for spleen diseases of the spleen including cysts, lymphomas, thrombocytopenias

2-3 hours

5-8 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

520-1,030 EURO
(1,000-2 000 BGN)

3,070 EURO
(6,000 BGN)

4,700 EURO

10. Specialized laparoscopic procedures for adhesion disease, acute and chronic intestinal obstruction or intestinal twisting

1-3 hours

5-8 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

1,030 EURO (2,000 BGN)

2,560 EURO
(5,000 BGN)

4,200 EURO

11. Laparoscopic abdominal wall hernia operations

1-3 hours

4-8 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

1,030 -2,050 EURO
(2,000-4,000 BGN)

2,560 EURO
(5, 000 BGN)

5,200 EURO

12. Proctology contemporary diagnosis and treatment of anal rectal diseases

0.5-1 hour

3-5 days

65 EURO (125 BGN) per night

45 EURO
(85 BGN)

1,540 EURO (3,000 BGN)

1,540 EURO (3,000 BGN)

3,500 EURO

 

*The package price does not include medical implants and/or very specialized medical laparoscopic consumables which include the following:  

  • Mesh implants
  • Single use laparoscopic circular or linear clip appliers
  • Single use laparoscopic fixation instruments
  • Laparoscopic biological glues
  • Single use laparoscopic electrosurgical tools

** The estimate price was calculated at the maximum hospital stay at the 65 EURO (125 BGN) per night rates, and the upper price range of the medical implants and consumables. The prices above are based on average prices and are subject to change. The currency conversion from the local currency BGN to EURO is based upon the fixed exchange rate of 1.95573055 BGN per EURO. The total medical costs can vary depending on implant options, service upgrades, and for medical reasons, however any price changes are subject to patient approval and consent . 

What does the medical service package include? 

 

  • Pre and Post procedural consultations
  • Comparative pre-post procedural X-rays zone of interest
  • X-rays and/or MRIs or CT to screen for infections or existing health problems
  • Clinical Tests to screen for existing health problems including:
    • Full blood chart
    • Blood typing
    • Biochemistry
    • Allergy testing
  • The operating theatre costs and anesthesiology costs
  • Post procedural physical therapy and rehabilitation
  • The hospital stay see table 1 above
  • 24 hour nursing and physician care
  • Hospital meals and medications during the hospital stay

Recovery milestones and back to work estimation: 

The estimated recovery milestones after laparoscopic procedures vary for each procedure and patient as detailed in table 2 below. However as a general timeline one could expect the following:

  • Restoration of the operated upon passage and to begin eating again
  • Moving around the hospital room on the day after the procedure, and walking in the corridor on the 2-3 day post procedurally.
  • Hospital discharge 3-8 days post-op
  • Ability to drive a car 5-10 days post-op
  • Able to travel back home 5-12 days post-op
  • Return to work estimation 2-4 weeks post-op
  • Exercise, sports and strenuous physical labor 3-8 weeks post-op

Table 2: Expected Recovery Milestones by Specific Procedure

Operation

Eating

Traveling Back Home

Driving

Return to Work

Exercise, Sports, and physical labor

1. Laparoscopic esophagus and stomach operations

2-4 days

8-10 days

6-8 days

14 days

4-6 weeks

2. Laparoscopic surgery for gastroesophageal reflux disease, diaphragmatic hernias, and hiatal hernias

1-3 days

6-8 days

5-6 days

10 days

3-4 weeks

3. Laparoscopic surgery for intestinal diseases

3-5 days

8-10 days

8-10 days

14 days

4-6 weeks

4. Laparoscopic surgery for gall bladder and bile duct diseases including stones and bile duct blockages

1-2 days

3-6 days

5-6 days

10 days

3-4 weeks

5. Laparoscopic surgery for acute and chronic appendicitis and appendix tumors

2-3 days

5-8 days

5-6 days

10 days

3-4 weeks

6. Laparoscopic surgery for diseases affecting the ovaries, fallopian tubes, and uterus: cystectomy, salpingectomy, myomectomy and adhesion correction due to previous  surgeries or pelvic inflammation

1-2 days

3-6 days

5-6 days

10 days

3-4 weeks

7. Specialized laparoscopic surgeries for overweight patients  including bariatric and endocrine procedures

3-5 days

8-12 days

8-10 days

14 days

4-6 weeks

8. Operations for liver diseases including liver cysts, echinococcus cysts, and tumors

1-2 days

6-8 days

8-10 days

10 -14 days

4-6 weeks

9. Laparoscopic surgery for spleen diseases of the spleen including cysts, lymphomas, thrombocytopenias

1-2 days

6-8 days

8-10 days

10 -14 days

4-6 weeks

10. Specialized laparoscopic procedures for adhesion disease, acute and chronic intestinal obstruction or intestinal twisting

1-2 days

6-8 days

8-10 days

10 -14 days

4-6 weeks

11. Laparoscopic abdominal wall hernia operations

1-2 days

6-8 days

6-8 days

10 -14 days

4-6 weeks

12. Proctology contemporary diagnosis and treatment of anal rectal diseases

1 day

4-6 days

4-6 days

6-8 days

2-3 weeks

 


What to expect before your procedure? 

Before the procedure we ask that you send our medical team a current medical exam report, x-rays, and a listing of all the medications you are currently taking. During your pre-procedural consultation your physician will review your medical documentation, perform X-rays, and clinical examinations to assess current your health state to plan your procedure. 

How long does the surgery last? 

The surgery lasts approximately 3 hours and can vary based on the medical complexity of your specific case: refer to table 1. Before your surgery, your anesthesiologist will consult with you to determine the best type of sedation general or regional anesthesia based on your medical profile.  Our operation theaters are located on the second floor of hospital and Minimally Invasive Surgery ward is located on the forth floor. 


Follow-Up care 

Specific check-up exam schedules are determined  based on the patient’s health condition and the type  operative procedure conducted. Typically, the first outpatient check-up examination is on the 8th day post-operatively, when the stitches are removed from the skin. In most cases the next scheduled check up exam is two to three weeks afterwards.  

Based on your recovery progress, your surgeon can recommend a visitation schedule to follow based on your specific case. Our surgical team is dedicated to maintain contact to advise and manage your follow-up care with your  doctor in your home country. 

Possible post surgical pain or complications
After surgery one may experience nausea,  pain, or discomfort especially in the location of  the surgical incisions. We administer contemporary post-operative analgesic schedules to minimize and manage any post operative discomfort.   

Surgical wound risk complications are rare (below 0.5%) for the termed “clean” operations, and up to 4% for operations involving opening hollow organs. Systemic risk complications such as heart attacks, strokes, and pulmonary thromboembolic events are low as well, below 0.5%. We use all established methods of prevention to manage these post operative risks. These complications are also possible during the late post operative period, and we will provide you with full instructions to act if any complications arise.

In your email include any medical records you have detailing your specific medical case including copies of x-rays, clinical lab results, and medical reports. Based on your medical records and case, our surgical team may require additional test results and/or reports provide you with a more accurate treatment plan and price quote. 

See more

Hospital location

51B "Nikola I. Vaptsarov" blvd. (if you drive, the entrance is from "At. Dukov" str.), "Hladilnika" distr., 1407 "Lozenets".

The hospital has a parking lot. The first 30 min. are free of charge, then a fee of 3 bgn/hours applies.

Public transport:
Buses: №88, 120
Shuttle bus: 32

Subway: Getting off at "James Bourchier" station, after that walking through "Lozenets" distr., or tram №10, taking off at "Nikola I. Vaptsarov" stop. or a bus №88, taking ff at "Tokuda Hospital" stop.

Map 

From the Central Railway Station

Bus line №305 getting off at "Romanian embassy" stop
From "Romanian embassy" stop – Bus line №120 getting off at "Tokuda Hospital" stop.
(after the traffic lights at "Atanas Dukov" str.

With a subway, from "Central Railway Station" station, getting off at "James Bourchier" station, after that walking through "Lozenets" distr., or tram №10, taking off at "Nikola I. Vaptsarov" stop. or a bus №88, taking ff at "Tokuda Hospital" stop.