G.O. Institute Los Angeles
Advanced Robotic Pelvic Surgery & Integrative Healing
Gynecologic Cancer Treatment
Personalized treatment options for ovarian cancer, uterine cancer, cervical cancer and cancers of the vagina and vulva.
Advanced Endometriosis Excision
Advanced endometriosis excision, using minimally invasive surgery, even when prior surgery has failed.
Ovarian Cysts & Pelvic Masses
Pelvic tumors and masses like ovarian cysts, ovarian masses or ovarian tumors, and uterine fibroids may require advanced surgery.
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** Don’t get surgery or treatment based on YESTERDAY’S science. Discover ALL your minimally invasive surgical, precision molecular medical and integrative holistic nutritional options!
21st Century Cutting-Edge Treatment Options
Surgical and medical therapy options are based on the latest best published research information.
Extensively Discussed & Applied to YOU as an Individual
Research studies are focused on hundreds or thousands of patients, SO how that is applied to you as an individual is critical to success.
Science-Informed Nutrition & Mind-Body
Many “alternative” and “natural” options are useless and harmful, but many are very helpful. We help you find what really works!
Hand-Held Guidance Throughout Your Experience
We believe the personal “human touch” to help guide you is crucial for your recovery and focus on making sure you are supported.
Your Health Is A Priority
Your Quality Of Life Is Too
Because of the benefits of faster surgical recovery and a focus on holistically restoring health, this means you are back with family and loved ones, thriving and enjoying the best that life has to offer
Meet Your Team
Dr Steve Vasilev MD
Integrative Gynecologic Oncologist
Quadruple board-certified in gynecology, gynecologic oncology & integrative holistic medicine. Alpha level expert robotic surgeon.
Lisa Stern PAC
Lisa’s personal attention to detail means you are always on-track and supported in your journey, from diagnosis through supportive care.
Hand-crafted for YOU !
Providence Saint John’s Health Center & Independent Consulting Providers
We help guide you from prevention through diagnosis, treatment and into survivorship by teamwork!
Distinctive Individualized Care Experience
We deliver higher-level limited-availability services by application review only, so when you are accepted as a patient you join us as a VIP and not treated as an impersonal number getting cookie-cutter “ok-level” care
….as we all know, “just OK is not OK”.
What Our Patients Say
In the end, what people say reflects the age-old saying “the proof is in the pudding”. We walk the talk and help people emerge from the other end as quickly as possible, with personal support.
Patricia B. / Santa Monica, CA
“Dr. Vasilev is a very caring doctor and that is really important. The whole team is focused on a caring attitude”
Sandra C. / Santa Monica, CA
“Heartfelt gratitude to my magnificent surgeon, Dr. Vasilev, to Lisa and to the entire team.”
Marion W. / Los Angeles, CA
“Dr Vasilev and his team were absolutely amazing. The robotic surgery was fantastic. ”
Appointments Extremely Limited
… Covid-Safe TeleHealth Consultations
Consultations very limited so we can concentrate on those we can help the most. Initial Covid-safe consult is online with testing and examination soon to follow and scheduled as needed.
Knowledge is empowering….
Frequently Asked Questions
About Gynecologic Oncology, minimally invasive gynecologic robotic surgery, advanced endometriosis excision surgery, precision cancer therapy, and integrative holistic medicine healing.
This website is here to provide you with education, information, and guidance to help you seek healthcare with the provider(s) of your choice. The topics are as listed and involve gynecologic cancers as well as endometriosis and complex pelvic conditions. The information is general and cannot replace medical advice from a provider with whom you have a trusting professional relationship. The information is about the standard and cutting edge approaches and in our blog, we also cover late-breaking news, human interest stories related to the gynecologic diseases mentioned and research updates.
If you choose to see Dr. Steven Vasilev MD as a patient you will receive care under the auspices of the Providence Specialty Medical Group, primarily at Saint John’s Health Center, owned and operated by Providence Saint Joseph’s Health System. If you choose to see another specialist, either listed on this website or not, we hope that the information contained herein helps you in your journey to health.
Keyhole “minimally invasive surgery”, which avoids open surgery and large incisions, is highly enhanced using robotically assisted technology using the Davinci surgical system. It makes the surgery far more precise because instead of straight instruments, which make instrument movements during surgery “herky-jerky” and imprecise far too often (similar to a novice eating with chopsticks), robotically assisted surgical instruments are finely controlled to avoid anything but smooth motion. In addition, the instruments have joints at the tips (like a hand and wrist) making them far more flexible for precision delicate surgery. Finally, the surgeon’s vision is magnified and in 3D, making the anatomy of the surgery much more clear. All of this translates to the ability to perform complex surgery safely and precisely, minimizing complications and optimizing healing. You benefit from a shorter hospitalization or sometimes can go home the same day.
Robotic surgery excellence for advanced cancer and endometriosis surgery demands far more than robotic training and certification. That’s the kindergarten level for beginners with the DaVinci surgical system. Experience matters in getting the result you want for difficult cancer surgery, re-operative surgery (multiple prior surgeries) and endometriosis excision surgery. It is not a matter of just how many cases the surgeon has performed but also how difficult they are. You can rest assured that Dr. Vasilev has more than 30 years of experience in advanced radical surgery, and has taught hundreds of physicians-in-training (residents and fellows) in precision radical techniques and surgeries deemed impossible by other surgeons. For almost a decade he has been using this advanced skillset using minimally invasive robotic surgery technology. The results can never be guaranteed but often can be nothing short of miraculous, combining radical yet meticulous surgery with 21st century robotic surgery technology and small incisions.
Minimally Invasive Gynecologic Surgery
For both benign and malignant conditions surgery is often the fastest, best or sometimes the only route to cure. When this is the case, large incisions are usually no longer necessary. Using 21st century robotically assisted technology it is possible to avoid long healing times and accelerate recovery. Faster recovery, less blood loss, and usually much less tissue damage is the result of this highly precise robotic surgical approach.
DaVinci Surgery Hysterectomy
Tiny incisions, often hidden below the bikini line and in the belly button, replace unsightly incisional scars in performing a hysterectomy. A few of the additional incisions may be visible but are the size of a pencil eraserhead and can heal in a way that they can be almost invisible. This less painful, rapid recovery, quality of life-preserving and body-image-preserving approach is availble for cancer and endometriosis surgery at the Gynecologic Oncology Institute. The surgery is done through small incisions and, in the majority of cases, the uterus can be removed via the vagina.
Advanced Robotic Surgery in Gynecology
Robotically assisted minimally invasive laparoscopic surgery has many gynecologic applications. If you have rapidly enlarging fibroids, a suspicious ovarian mass or cyst, diagnosed cancer of the uterus, cervix or ovaries, endometriosis or other gynecologic surgical conditions, the Gynecologic Oncology Institute may be a good fit for you. Dr. Steven Vasilev MD is a surgeon with over 30 years of experience and, with his team and colleagues, can help you with surgery that offers the fastest possible recovery and the results you want. We specialize in bringing minimally invasive surgery to help heal difficult gynecologic conditions, including advanced cancer and endometriosis.
Robotic Surgery Recovery Time
Studies show that recovery from minimally invasive surgery is much faster in terms of going home faster, getting back to your routine quicker and healing better with less external and internal scars. While this is true of laparoscopy as well, robotic surgery is performed with less torquing of the instruments at the muscle of your abdomen and less ripping and tearing internally. This means less pain and less tissue damage, which means healing is optimized. It’s all about recovery, to get back to life or the next phase of your treatment as soon as possible.
One in ten women have endometriosis, whether or not there are symptoms. Endometriosis is a benign condition and, while it is almost never life-threatening, can behave like ovarian cancer by invading local organs like the bladder and bowel.
Symptoms are usually related to pelvic pain, but very often the main symptom is bloating. Bloating is often considered a symptom of ovarian cancer. So, how does one tell the difference? The problem is that you can’t. The likelihood is that you are “OK” based on pure numbers and rarity of associated cancer….until it is not OK in any given individual.
While we know the risk of associated ovarian cancer or malignant degeneration to cancer of the endometriosis itself is very low (<1%), it is still a concern. Even 1% of the estimated 15 million women who have endo in the United States (one in ten women) means that up to a hundred thousand women may end up with a related cancer during their lifetime. Most often, this happens in older women and may be influenced by uncommon genetic mutations that are shared between cancer cells and endometriosis. A gynecologic oncologist can help guide you to make sure you are at as low a risk as possible and operate to diagnose and remove endometriosis if the suspicion is high. Gynecologic Oncology Institute is a referral center for concerns regarding endometriosis and cancer and we are happy to help evaluate, reassure or treat when needed. Read more about endometriosis and cancer HERE.
Endometriosis grows on and into tissues just like cancer, making excision as difficult as the most challenging cancer surgery. The tissues that can be affected are bowel, your bladder and the ureters (which connect the kidneys to your bladder), liver surface, diaphragm surface and anywhere in your body. These are all delicate structures that require a very different and highest level skill-base for safe surgery, such as those of an oncologic surgeon who has not only received extra training in this but is also board-certified in gynecologic surgery involving the bladder, ureters, colon, small bowel, liver, spleen, and diaphragms.
For this reason, and because of the increased risk of ovarian cancer in endometriosis patients, you should consider a gynecologic oncologist to be involved in your surgery. Dr. Vasilev collaborates with other surgeons, including other endo-excision surgeons, to get you the best outcomes.
Robotic Endometriosis Implant Excision
In addition to the above, in a significant percentage of cases, endometriosis can actually degenerate into or be associated with gynecologic cancer. When this happens it is usually later in life, but it is best when your surgeon can handle whatever is required during surgery. Experience matters and level of skills are critical. Today’s gold standard for endometriosis surgery is robotically assisted minimally invasive excision of endometriosis as part of an overall treatment plan which includes medical/hormonal treatments.
While simple laparoscopy can accomplish the same result in skilled hands, this is generally only true with less advanced endometriosis. Many argue this point, but robotic technology is inherently vastly superior and allows meticulous endometriosis excision under magnified 3-D view with instruments that are more like tiny little hands rather than straight scissors and graspers reminiscent of clunky chopsticks. The number of incisions can be very similar or exactly the same in skilled hands. For advanced endometriosis excisional surgery the Gynecologic Oncology Institute stands among the best under the leadership of alpha-level robotic surgeon Dr. Steven Vasilev and his team.
Endometriosis Excision Surgery
Advanced endometriosis and complex gynecology problems, such as large and rapidly growing uterine fibroids, as well as ovarian masses suspicious for tumors, require advanced skill pelvic surgeons to get the best outcomes. We offer treatment and surgery for these conditions and more. Dr. Vasilev’s uber experience and advanced skill-set in surgery transcend to the next level. He is often called upon to help where other surgeons have not succeeded. These skills, combined with high-tech robotics minimally invasive surgery, and warm-touch integrative holistic support sets us apart. You get a shorter hospitalization or no hospital stay, and no open surgery incision to have to heal from.
Large and Rapidly Growing Uterine Fibroids
Uterine myxomas, or fibroids, are very common. Up to 80% of all women have them. However, when they become very large or are rapidly growing there is an increased risk of cancer (sarcoma) and surgery to remove them becomes very challenging. We offer second opinions and work with your referring physicians to determine the best course of action, including advanced robotically assisted surgery.
Pelvic Masses and Ovarian Cysts
Not all cysts of the ovary are dangerous, and some are “physiologic”, meaning they normally come and go with menstrual cycles. But those that persist or are growing or occur after menopause can be tumors, which can be benign or malignant. We offer all of the diagnostics to help determine which is which and offer advanced minimally invasive surgery where needed.
Premalignant Ovarian Tumors
Some ovarian masses which have suspicious characteristics on ultrasound can be “low malignant potential” or “borderline”. These can be tricky in that some are actually overtly malignant, while others behave like they are benign. A gynecologic oncologist should be involved in your care in these situations for the best outcomes.
First of all, what are ovarian cysts, how did they get there and are they all the same kind? If you did not ask these three questions, you may be on the wrong path towards getting rid of the type of ovarian cysts that you have. If someone tried to treat you without explaining the differences, you may be working with the wrong doctor.
You’re not alone in having any of these ovarian cysts, but there are DEFINITELY more than a few different kinds. Literally millions of women have various types of cysts grow on their ovaries during their lifetime, sometimes once and sometime many times. The key to successful treatment and prevention is to realize that there is no “one-size-fits- all” type of “cure”.
It is important to understand that most ovarian cysts can be successfully treated medically and naturally, but ovarian tumors can’t. Tumors can be benign or malignant (cancer), but they NEVER go away on their own and can threaten your life. This is a crucial distinction that you need to find the answer to before wasting time or putting off a surgery that you might really need. In some cases, that surgery can save your life. On the other hand, you need to know enough to avoid a surgery you may NOT need. You are about to learn about all of this and how to find out what else you need to know to make the right choice for YOU!
If you have endometriosis, the chances are very high that it will be growing on your ovaries, forming cystic masses called endometriomas. Endometriosis is a benign (not cancer) condition or disease where cells and tissue of the same type that are normally found inside the uterus (endometrium) start growing outside the uterus and mostly inside your pelvis…..in the area that your ovaries and bladder and rectum are located. The good news is that even though 70% of women with endometriosis have it growing on their ovaries, only 5% actually develop a significant size endometriotic cyst that actually causes problems. Also, a small percentage (<1%) can develop cancer. So, cysts are largely benign and can go away on their own. Tumors are a subset and usually require surgery. Cancer is even a smaller subset, but it can threaten your life. Find out what is going on in your body with an understandable opinion from a doctor that you connect with.[/st_item_accordion][st_item_accordion heading="What gynecologic cancer treatments do we offer?" content_source="editor" page="" icon="fa fa-plus-circle" tag="" disabled_el="no" ]Precision cancer treatment uses cancer’s genomic DNA blueprint against itself, targeting cancer with smarter more precise attacks than standard empiric chemotherapy. Other than surgery and precision genomics-based therapies for cancer, we offer:
HIPEC Intraperitoneal Cancer Treatment Program
Heated intraoperative intraperitoneal chemotherapy is fast becoming a standard of care option for treatment of advanced malignancies, including ovarian cancer. At Saint John’s we can offer you safe high-tech state-of-the-art HIPEC. If you have been diagnosed with ovarian or advanced endometrial cancer, this may be an option for you when combined with interval cytoreduction surgery. Our cytoreduction approach is often minimally invasive using robotic technology, in order to avoid larger incisions.
HIPEC Ovarian Cancer Success
Indications for HIPEC
For our cancer patients, YOU are different and unique. Every cancer is also different and not just based on what organ it came from (e.g. ovary)! Cancers differ at the genomic and molecular level. Both you and your cancer ALSO change over TIME. So why be treated like “everyone else” with the same old “standard” treatment plan? YOU deserve personalized therapy!For example, it was recently reported that the median overall survival was eight years longer in ovarian cancer patients treated using molecular profiling. The future is here!
Cancer Treatments Designed Uniquely For You
Cookie-cutter “one size fits all” medicine will soon be history. You owe it to yourself to discover the difference. Science-based cancer therapy combined with a personalized approach is the 21st century way to treat malignancies. It’s the ultimate way to optimize your chances to beat cancer and includes the very best of 21st century surgery, Western and Eastern medicine. Come see us: Survive and Thrive!
Our approach is very detailed and complex and is, by definition, very individualized. We take “personalized cancer therapy” and survivorship to the next level, as follows:
Primary Cancer Prevention and Cancer-Proofing
Cancer is partly genetic, but also largely related to lifestyle choices. In general, you have a large say-so in whether or not you get cancer. Screening and lifestyle choices modification goes a long way towards avoiding many cancers.
Molecular Assisted Screening and Risk Reduction
Today’s screening is advancing at a rapid pace and involves cutting edge molecular tools. It is appropriate for some, but not for all, depending on your risk. In some cases, like Angelina Jolie, risk reducing surgery can be lifesaving. All of this is highly individualized to you, and can apply to endometriosis patients as well.
Gynecological Minimally Invasive Robotic Surgery
Today’s surgery is far less invasive, even for bigger or more extensive gynecologic cancers which normally require large incisions. Minimally invasive surgery allows you to recover faster, get back to life quicker or get to the next phase of treatment (when required) much faster. For pre-cancers or extensive benign diseases, like advanced endometriosis or complex pelvic masses, robotically assisted surgery can make all the difference towards fast recovery.
Molecular Tumor Profiling and Precision Treatment
Cancers are different from organ to organ, body to body, one point in time to another and from one area to another. This is all based on the genomic alterations or mutations that occur in cancer cells, which change over time and from one tumor to another. Techniques called next-generation sequencing (NGS) or molecular profiling can look for mutations that can be attacked precisely using the newest biologic agents. Testing can be done on tissue or blood (liquid biopsy), and usually both. This forms the basis for personalized treatment plans for cancer.
Molecular Nutrition and Biome Profiling
Anti-cancer nutrition and optimization of your microbiome is central to “cancer-proofing” your body as much as possible to prevent cancer or even reducing the risk of recurrence. Everyone is different but, in addition to a baseline optimization of your nutrition and microbiome, there are science-supported strategies that are based on biomarkers and genetic polymorphism analysis.
Complementary Natural Holistic Support
Integrative holistic medicine takes the best of natural and complementary support modalities to help reduce symptoms caused by disease, help get at the root cause of these symptoms and help you survive and thrive through treatment and far beyond. From nutrition to acupuncture, targeted supplements and herbals, mind-body techniques and much more, supporting and enhancing your disease-fighting ability is crucial to your success in beating any debilitating disease, including cancer.
Cancer Recurrence Risk Reduction Planning
After treatment is over there is much you can do to proactively enhance your mind and body to fight off disease and do everything possible to ward off a recurrence. So, if your current post-treatment plan is “watchful waiting” with tumor markers and scans, you need an opinion at the Gynecologic Oncology Institute. Discover the difference!
Maximize your chances to defeat your gynecologic cancer and/or reduce your risk of recurrence using our unique combination of standard therapies integrated with complementary holistic natural support towards a thriving survivorship. The goal is to “cancer-proof” or “anti-cancerize” your body as much as possible. Basically, this means making your body as inhospitable as possible to cancer growth, while using all available targeted precision therapies to interfere with cancer-promoting pathways.
Endometriosis is also an inflammatory disease, like cancer, and that is partly why there is a connection between ovarian cancer and endometriosis. It is far more complicated than that, but integrative healing can help improve life and treatment for endometriosis as well.
Natural healing approaches
Integrative healing includes nutrition, life-style modification, toxin avoidance, targeted supplementation, mind-body support, biofeedback and energy medicine. These cannot replace mainstream therapy. However, while “alternative” hype and junk therapy are useless, integrative natural holistic complementary healing is essential for your recovery and for thriving in survivorship.
Nutrition and Cancer
Microbiome Analysis and Management
Mind-Body Cancer Care
Integrative Cancer Recurrence Risk Reduction
After surgery and/or cancer treatment the goal is almost always to cure or at least promote good quality-of-life remissions, measurable in years. Having faith and a good attitude is important, but simply hoping cancer will not return is not a good strategy for recurrence prevention. There are many natural approaches to cancer-proof your body to reduce the risk of recurrence as low as possible. In addition, there are biological therapies available for some cancers that also reduce the risk of recurrence or at least delay recurrence for many months or years.