5-Minute Intro Video: Robotic Excision + Integrative Care
Frustrated By One-size-fits-all Incomplete Solutions?
Get Expert Endo Excision....
Wrapped in Personalized Integrative Care
Next-Level High-Tech Warm-Touch Care:
Personalized Navigation Throughout
Complete evaluation of you, your records & images
Organizing additional testing
Thorough review of treatment options
Perioperative integrative healing options
Master surgeon expert robotic excision surgery
Longterm Integrative Thrivorship plan
Don't be crammed into one-size-fits-all solutions!
DISCOVER Your Best Path(s) Forward To a Better Place....
Integrative Advanced Minimally Invasive Pelvic Surgeon
I'm Dr. Steve Vasilev, and I'm America's first and only triple board certified holistic and integrative physician who specializes in ultra-advanced robotic surgery and integrative recovery for endometriosis.
What does this mean for you?
My team and I listen and seek to fully understand your unique endo journey
Beyond advanced robotic excision surgery we optimize your perioperative course with integrative support.
We look at you as an individual in crafting a personalized Thrivorship plan.
Meet Your Team
Alese Barboza AA
Administrative Assistant (all locations)
You can count on Alese to help connect you with us, help secure authorizations, answer navigation questions about testing and more.
Lisa Stern PA-C
Physician Assistant Santa Monica
Lisa’s personal attention to detail means you are always on-track and supported in your journey, from diagnosis through supportive care.
Marisa Barber PA-C
Physician Assistant Avila Beach
Marisa's role in Avila Beach and San Luis Obispo, is the same as Lisa's in LA, guiding you through your journey.
Robotic Surgery Endometriosis Excision Outcomes
The national published excision outcomes, usually measured at five years, are multifactorial, but are generally in this range:
- After primary excision, up to 67% with moderate to severe endo, especially when <35y of age
- After repeat surgery 20-40%
- Endometrioma recurrence 15-20% at two years
- Complete excision 3.9% vs 35% with incomplete
- 15% without family history vs 40% with
- Higher risk with high mitotic index or gene mutations
Although basic minimally invasive and robotic techniques are more available than ever before, the degree of experience in endo excision per se is still very limited, even among some fellowship graduates and especially in advanced or recurrent cases.
Regarding OUR surgical expertise and outcomes with robotic surgery, from focal to widespread endometriosis, we are very unique on the West coast due to our master surgeon's approach rigorous surgical excision approach and our integrative support.
We apply a very specific surgical excision "R" and "C" scoring technique used in multi-organ and multi-quadrant ovarian cancer surgery, where life is literally on the line. This requires as close to so called “complete” R0 or CC0 excision as possible.
OUTCOMES: Although HIPAA prohibits details of patient information sharing, in our hands, this meticulous and rigorous surgical approach has resulted in excision of all visible disease in virtually all of our primary excision patients.
Even with repeat surgery patients, with severely distorted anatomy and fibrosis, complete or near complete excision has been the norm while keeping complication rates at almost zero and less than 1% conversion rate to open surgery, or laparotomy.
Almost all surgeries were outpatient or required a very short stay (<1d) in the hospital. As far as recurrences, we are aware of only several patients over the last 6 years out of hundreds, many of whom had advanced disease.
Integrative Healing & Solutions Beyond Excision
Surgery is a critical cornerstone in most cases for one reason or another, but is often not enough!
Published outcomes statistics are pretty clear on this, and there are options:
- Suppressive therapy significantly reduces recurrence
- Complete excision with suppression works better than drug/hormonal therapy alone
Beyond the standard hormonal options, our unique approach is that we offer an integrative comprehensive healing strategy, using the best of mainstream assessment and treatment, combined with holistic science-grounded natural support for optimal surgical preparation and long term thrivorship. This includes hormonal balancing without exogenous hormones, which can also help suppress recurrence.
Enhanced surgical and endo recovery outcomes are potentially achieved by using an expanded Enhanced Recovery After Surgery (ERAS) protocol, which blends integrative medicine into the proven algorithm and beyond. This may include acupuncture, dietary modifications, botanicals, and stress reduction, which helps further reduce inflammation and promotes well-being. This combination facilitates faster recovery, reduces complications, and improves quality of life.
OUTCOMES: Although HIPAA prohibits details of patient information sharing, in our hands, this combined approach results in improved healing and better symptom control as well as optimized chances for a recurrence-free life.
