Tokuda Hospital Sofia


The Urologists at Acibadem city Clinic Tokuda Hospital Performed the First Robot-assisted Cystectomy with a Urinary Bladder Reconstruction in Bulgaria

25 january 2018

The patient’s urinary bladder should have been removed because of an oncological disease

In Bulgaria cystectomy is usually made with an open surgical incision. For a couple of years Tokuda Hospital has been established the practice where the radical removal of urinary bladder is achieved through a laparoscopic method by means of a few small holes in the abdomen. The robot-assisted cystectomy with DaVinci surgical system is a natural evolution of the skills and technological development of the urology team headed by Dr. Kaloyan Davidov. Dr. Asen Aleksandrov, Dr. Adrian Popov and surgical nurse Raya Chonkova also took part in the procedure. At the operation that lasted for about 6 hours first the urinary bladder and the adjoining lymph nodes in the pelvis were removed, then a new bladder was constructed. It is a urinary reservoir made of the patient’s small intestines, which creates the mechanism to carry away the urine and it is possibly the closest to a natural bladder. The construction of a urinary reservoir is an alternative which saves patients from taking the urine out of the body through artificially made openings and makes it possible for them to keep the optimum lifestyle quality.

The advantage of robot-assisted cystectomy to a laparoscopic one is in the exceeding precision of the robot. The system has a ten-fold optic magnifying option to the 5-fold magnifying option of a laparoscopic system, which provides much better look at the operation field.  The DaVinci instruments are created with human hand dexterity, which the laparoscopic instrumentarium lacks and which gives extremely surgical precision. For a patient it means minimal blood loss, minimal trauma and faster recovery.

Radical prostatectomy with robot-assisted surgery is now a routine procedure while robot-assisted cystectomy with the construction of an artificial bladder is a unique operation in Bulgaria and it is relatively rare in Europe. The operation is very complicated and needs to be performed by highly qualified multidisciplinary team, with the respective technology and infrastructure. “You need is team that is made up  not only by surgeons but also extremely professional anesthesiologists and reanimators without whom we could not have taken such an avant-garde approach…Big surgery is a process, it is not an event and not all hospitals possess all that is combined here.”, said the Head of the Urology Department Dr. Kaloyan Davidov.

Recently Dr. Asen Aleksandrov has joined the team certified for robotic surgery after his training in Germany. The extension of the team makes it possible for the surgeons to get together and work in a combination, thus ensuring a higher quality of the surgical procedure, concentration and efficiency at any moment of the operation.

In 2017 about 20 laparoscopic cystectomy were performed in Tokuda –more than half of them are related to the construction of a new urinary bladder.

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Hospital location

51B Nikola Y. Vaptsarov Blvd., Sofia, 1407 (if you drive, the entrance is from Atanas Dukov str.)

The hospital has a parking lot for patients and visitors. The first 30 min. are free of charge, every next hour is 3BGN/hrs.
IMPORTANT! Have in mind that the parking lot is very busy Monday to Friday between 10.00 and 14.00. The hospital team will appreciate if those whose health condition allow, take the drop off option without parking or use other transport means or alternative parking lots in the area.

Public transport:
Buses: №88, 120

Metro lines: You can get off at James Bourchier or Vitosha metro station and walk to the hospital.


From the Central Railway Station

Bus: take bus #305 and get off at Romanian Embassy stop, then transfer to bus #120 to Tokuda Hospital stop.

Metro: Take metro line Nadezda-Lozenetz and get off either at James Bourchier or Vitosha metro station, then walk to the hospital.