Steven A. Vasilev MD MBA FACOG FACS FACN ABIHM ABOIM
Medical Director, G.O. Institute Los Angeles
Complex Gynecology, Oncology & Minimally Invasive Robotic Surgery, Endometriosis Specialist
City: Santa Monica, Beverly Hills & San Luis Obispo, CA, USA.
Dr. Steve Vasilev is a renowned minimally invasive pelvic and abdominal surgeon who pioneered complex laparoscopic and robotic surgery, with over thirty years of experience treating endometriosis and cancer. Known as the go-to surgeon for advanced disease, he often takes on cases deemed inoperable by others. He is a surgeon supporting other excision surgeons due to his board certification to operate on all abdominal and pelvic organs. Having performed thousands of advanced complex surgeries, he has taught hundreds of residents, fellows, and colleagues these specialized techniques as faculty and professor at UCI, USC, UCLA, City of Hope, and Loma Linda. Dr. Vasilev is the only physician triple board-certified in the United States in Ob-Gyn, Oncology, and Integrative & Holistic Medicine. This background and experience are surgically unsurpassed and support his multidisciplinary holistic approach to endometriosis. Above all, he is well-known among his patients as a down-to-earth, compassionate listener.
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Philosophy: In addition to being a doctor and surgeon, I am a clinical researcher and translational scientist. We are studying the molecular behavior of endometriosis in our laboratories. Endometriosis theories suggest multiple causes, and each thesis
contributes to factors likely tied together at the molecular genetic level. Identification of endometriosis molecular and immunomodulatory pathway biomarkers will soon lead to better non-invasive diagnostics, accurate monitoring, and effective therapies beyond the baseline of expert excisional surgery and hormonal manipulation. I focus on this and the uncommon but clear overlap with malignancy in older endo patients or those with a family history.
Surgical excision is a critical cornerstone for endo diagnosis, initial treatment, and re- excision of recurrence or pain-producing fibrosis. My philosophy is to be fully informed and prepared, no matter the findings, through optimal pre-operative imaging and testing. Fortunately, my unique training and board certifications permit surgery on all abdominal or pelvic organs, including small and large bowel, ureters, bladder, liver, and diaphragm. If disease is suspected beyond these organs, such as the chest, we have expert cardiothoracic and neurosurgeons ready to join a multi-disciplinary surgery. Having used both laparoscopy and robotics in thousands of surgeries over three decades, including the hardest of the complicated surgeries, I firmly believe that the far superior 3-D camera optics and articulating or wristed “tiny hands” instruments used in robotics are better than traditional laparoscopy for all but the simplest of cases. When complicated anatomy or scarring from endo and fibrosis is unexpectedly found, which is not uncommon because endo is intensely inflammatory, the ability to see better and use finesse instruments makes all the difference, especially in highly experienced hands.
Medication: During the perioperative period, we use holistic ERAS-modified care, combined with integrative modalities such as acupuncture and acupressure, to allow faster recovery with lower narcotic use. We individually construct and coordinate a multidisciplinary consulting team of experts to manage pain, intestinal manifestations such as SIBO and pelvic floor dysfunction. We work with referring gynecologists regarding hormonal support but discourage using GnRH-based therapies. My board certification in Integrative Medicine uniquely injects additional options involving holistic care. An example is proactive estrobolome management to lower systemic estrogen levels naturally.
Approach to Persistent Pain: Both pre- and post-operatively, I strongly encourage pelvic floor therapy and pain specialist consultation and follow-up. The genesis of endo-induced pain can be due to endometriosis implants and peripheral visceral and parietal peritoneal nociception, fibrosis, direct nerve impingement, pelvic floor dysesthesia, or central sensitization. A very individual approach is vital to the best management plan. In primary and persistent pain situations, each of these “medicalese” terms is discussed in detail to craft the best possible personalized plan. Finally, as noted above, I am a board-certified integrative medicine practitioner and thus apply Eastern thought such as acupuncture, mind-body strategies, and personal nutritional counseling and interventions.
Dr. Steve’s articles:
Dr. Steve’s books:
- Ovarian Cyst Treatment
- Cancer Cureology: The Ultimate Survivor’s Holistic Guide: Integrative Natural Anti-Cancer Answers: The Science and Truth