On June 25, 2025, the Clinic of Oncologic Surgery at Dr. Georgi Stranski University Hospital – Pleven performed the first robot-assisted breast cancer surgery using the Da Vinci X system in Bulgaria – a breakthrough achievement for the country and the region.
The operation was led by Prof. Dr. Dobromir Dimitrov, Head of the Clinic and Rector of Medical University – Pleven, alongside Assoc. Prof. Dr. Martin Karamanliev, with consulting support from Prof. Dr. Tashko Deliyski and Dr. Chavdar Bachvarov (plastic surgery specialists from Dr. Tota Venkova Hospital – Gabrovo). The anesthesia team was headed by Dr. Slavina Yohanova, Head of the Third Department of Anesthesiology and Intensive Care.
The team successfully performed a nipple-sparing mastectomy with immediate implant reconstruction through a single-port, minimally invasive 5 cm incision. The 38-year-old patient recovered quickly, was discharged on the second postoperative day, and experienced no complications.
“Preserving the nipple and sensitivity after mastectomy is now possible thanks to the precision of robotic surgery – improving both oncological and aesthetic outcomes,” shared Prof. Dimitrov. “This is the future of breast cancer treatment: less invasive, more precise, and focused on patient quality of life.”
This advancement is part of the activities under BG16RFPR002-1.014-0002 – Center of Competence for Personalized Medicine, 3D and Telemedicine, Robotic and Minimally Invasive Surgery “Leonardo da Vinci” at Medical University – Pleven.
The first robotic mastectomy using Da Vinci technology was performed in 2015 in Milan, Italy. Since then, it has become an increasingly preferred option globally, particularly for patients with early-stage disease or genetic predispositions.
The goal of the Pleven clinic is to join the leading European centers pioneering robot-assisted breast cancer surgery — a mission that underlines Bulgaria’s commitment to medical innovation and patient-centered care.
