Author: BCI

The team is part of the only gynaecology department in the country equipped with the latest generation equipment for robotic, hysteroscopic, conventional and 3D laparoscopic surgery

The ‘Mama and I’ clinic, part of the high-tech ‘Heart and Brain’ hospital complex, now has the latest generation system for performing minimally invasive laparoscopic surgeries. The technology provides the highest image quality with 4K resolution, simultaneous 3D picture and the possibility to use infrared filters to visualize the fluorescent dye indocyanine green (ICG). The clinic team is the only one in Bulgaria with the complete Rubina system and has the knowledge and skills to use it to its full potential.

“It can be said that we are pioneers in introducing this state-of-the-art treatment into surgical practice in our country. The technical capabilities are at a level never known before – every detail, even the tiniest, can be seen quite clearly and in three dimensions, which greatly improves the perception of the surgical space. The detailed visualization of the anatomical structures, especially when they are pathologically altered by various diseases, allows even more precise performance of operations”, says Dr. Alexander Lyubenov, Head of the Department of General and Oncological Gynecology, who has already performed the first operation with the new system.

“And for us, the specialists, the benefits of the new technologies are many – the image is of the highest quality and thanks to the 3D image, the feeling is that you literally sink into the deep spaces of pelvic surgery,” says Dr. Lyubenov.

The Rubina system is extremely suitable for complex and interdisciplinary surgical interventions, such as those often required in oncological diseases, severe endometriosis, prolapse of the female genital organs using flaps or natural tissue, as well as in reproductive surgery. The fluorescence technology built into the system allows the detection of lymph nodes in oncological diseases, as well as the assessment of the blood supply to the bowel in resections in abdominal surgery – methods that have established themselves as the gold standard in leading clinics in Western Europe and the USA. The new system ensures safer and more precise performance of complex gynaecological, urological and surgical interventions, providing even better and higher quality treatment for patients.

The Heart and Brain Neurology Clinic team, led by Prof. Plamen Bozhinov, MD, presented the outstanding success of non-invasive brain stimulation in stroke patients at the 10th Congress of the European Academy of Neurology (EAN). The event took place in the capital of Finland from 29 June to 2 July 2024. As one of the pioneers in the field of therapeutic neurophysiology in the country, Prof. Bozhinov and his team demonstrated the results of applying the method in their clinical practice.

“I am extremely proud of the results achieved in Pleven. Repetitive Transcranial Magnetic Stimulation (rTMS) is indispensable in the early rehabilitation of patients who have suffered strokes, in the treatment of various pain syndromes, Parkinson’s disease, Alzheimer’s disease, neuro-psychiatric development disorders in autism spectrum disorders, etc.,” says Prof. Bozhinov. It is no coincidence that the main topic of the congress was non-invasive brain stimulation in various neurological diseases. Modern neurological science is increasingly moving towards the use of various devices for such stimulation. This does not contradict drug therapy, but in most cases complements it. In pTMS we direct repetitive magnetic pulses at specific intervals to specific areas of the brain. These pulses reach brain cells, stimulate them and improve communication between different parts of the brain. Our experience in applying this therapeutic method includes monitoring more than 1,500 patients with a wide range of neurological and psychiatric diseases, including about 200 stroke patients,” adds Prof. Bozhinov.

During the congress, Dr. Stoyan Bozhinov, a neurology resident, presented results of EEG follow-up of the effect of rTMS in early rehabilitation of patients who have had strokes, and Polya Lambeva, a master’s student in medical rehabilitation and occupational therapy, presented the experience of the nervous diseases clinic related to the effect of non-invasive brain stimulation in patients with Parkinson’s disease.

The attention of the audience was also drawn to EEG (electroencephalographic) monitoring of patients with impaired consciousness in the ICU or intensive care unit setting. Great progress has been made in this area, with strictly defined EEG markers concerning good or poor clinical prognosis being identified.

“In , Heart and Brain’ EEG monitoring of patients with disorders of consciousness has been routinely used in clinical practice for about 3 years. Together with Dr. Vladislav Genov, Head of the Department of Anaesthesiology and Intensive Care, we have a great deal of clinical experience involving the monitoring of comatose patients of various backgrounds. Also of interest are the reports on the treatment of neurological diseases during pregnancy, the administration of different types of medications in pregnant women with epilepsy, and the management of possible complications of eclampsia (seizures). Together with the team of Assoc. Yordan Popov, Head of the Clinic of Obstetrics and Gynaecology at ‘Heart and Brain’, we have unique for our country practical experience in the follow-up and treatment of pregnant women with all neurological diseases”, summarized prof. Bozhinov.

“The European Academy of Neurology gives the continent’s leading specialists the opportunity to ‘check their watches’ with all the latest advances in neurological science and practice. In this way, we can be of maximum use to our patients and our colleagues in solving complex and difficult to diagnose and treat clinical cases, bordering between different medical specialties,” the neurologists concluded.

The procedures are performed by a urologist after a preliminary assessment of hormonal status by an endocrinologist 

A joint team of urologists and endocrinologists applies procedures with the latest generation shock wave therapy device. This is a non-medication and non-operative treatment that complements the complex therapy for erectile dysfunction, chronic prostatitis, Peyronie’s disease and gives excellent results, informs Dr. Silvia Ganeva, head of the department of endocrinology and metabolic diseases at the high-tech hospital.

The procedures are performed by a urologist after a preliminary assessment of the hormonal status by an endocrinology specialist.

“In shock wave therapy, painless pneumatic pulses are generated by the device and directed to the tissues. This achieves a number of positive effects, such as improving blood supply with anti-inflammatory effect, enhancing recovery processes and innervation,” explains Dr. Georgi Ivanov, a specialist in the urology department.

The procedure takes between 10 and 15 minutes depending on the area treated and the disease. The complete therapeutic course includes 6 to 8 treatments once or twice a week. With shockwave therapy, the need for and cost of medication is reduced. The method is scientifically proven to be highly effective, with high patient satisfaction with its application and lasting benefits for patients.
Treatments are paid for, with prices included in the hospital’s basic price list.

The observations of the specialists at ‘Heart and Brain’ indicate that erectile dysfunction is an increasingly common problem among men of active age. Worldwide, it is estimated that 10% of men between 40 and 70 years have a complete loss of erection. Partial loss of erection is experienced by 30-40% of men in this age range, with the incidence of the disorder increasing to 70% in men over 70. Many factors are thought to cause erectile dysfunction, with half of patients having organic causes brought on by chronic diseases such as arterial hypertension and diabetes mellitus. Frequently used antihypertensive, lipid-lowering medications and antidepressants can also exacerbate the problem.

Chronic prostatitis is an inflammation of the prostate gland that is recurrent. A significant percentage of cases are due to bacterial infection, most commonly caused by Escherichia coli. It is estimated that more than 8 million people worldwide consult a urologist for complaints of chronic prostatitis, and between 2 and 16% of men have manifestations of the disease at some point in their lives, Dr Ivanov says.