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 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.


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.