An extremely difficult operation was performed at the Acibadem Sistina Clinical Hospital, during which a 18 cm tumor was removed from a 62-year-old patient. The tumor was located in a specific place in the abdomen, on a difficult access area and what made the intervention even more difficult was the fact that it penetrated in the large inferior vena cava.

The patient is currently in a very good condition, and the performed intervention once again proved the paramount quality of “Acibadem Sistina”, as a clinic in the region where such difficult operations are performed. Prof. Vladimir Dimov, a general and abdominal surgery specialist under whose guidance the intervention was performed, says that usually in this area, this type of surgery is not a routine, i.e. very often patients are declared inoperable with an explanation that the disease is in a stage where nothing can be done and eventually they are sent for treatment to foreign large clinics.

The successful intervention was performed on a patient who was diagnosed with an upper abdomen retrooperative tumor region, an area that is anatomically located behind the abdomen, where the kidneys, pancreas and all blood vessels are located. The area is specific, difficult to access, because the tumor was located above the renal veins behind the liver where the vein and aorta are placed.



Vladimir Dimov

“What was further complicated was that the tumor also penetrated the large inferior vena cava, or cava, in which it obliterates almost 90 percent of its lumen. This position requires the tumor to be removed along with part of the vein because only then can it be removed completely. It is a very complex operation that requires a multidisciplinary approach. This kind of surgeries have huge risk on patient’s life, such as thrombosis or bleeding. Yet, thanks to the hospital equipment, experience and knowledge of the medical team this ended very well, with minimal blood loss. The patient is in very good condition and I must emphasize that such tumors are treated only in eminent clinics, in specialized health centers. Quite often these cases are declared inoperable,” said Prof. Dimov.


Acibadem Sistina Clinical Hospital with this intervention displayed that with its equipment, staffing and multidisciplinary approach is a place where extremely complicated surgeries are solved, which basically are performed only in large medical centers worldwide. The experience of the team of doctors was of crucial importance in this dangerous and risky operation, and in addition to Prof. Dimov, in the intervention Mitko Karagjozov MD, thoracovascular surgeon, Alen Jovcevski,MD abdominal surgeon and Monika Simonovska MD, participated, as part of the abdominal team.