Gynecologic Oncologists - Often Your Safest Choice for Endometriosis Surgery
How oncology-level training can translate to more effective surgical outcomes for endometriosis — even when you don't have cancer.

Understanding Why Surgeon Training Matters for Endometriosis Care
Endometriosis is inherently unpredictable. Even with excellent imaging and careful evaluation, the true severity of the disease often isn’t fully known until surgery begins. It can hide behind organs, wrap around the bowel or ureters, distort anatomy, mimic other conditions, or spread farther than imaging can reveal. As a result, cases that appear moderate beforehand may prove far more complex during surgery, and that level of complexity requires a surgeon with advanced training.
This is where the training of your surgeon becomes critically important, because handling advanced disease safely depends on a depth of surgical experience that not all specialists possess.
Why Would a “Cancer Surgeon” Operate on Endometriosis?
Many patients understandably wonder why a surgeon trained in cancer care would be involved in treating endometriosis. Even though “gynecologic oncology” sounds like a cancer-only specialty, these surgeons are actually trained at the highest level of pelvic surgery that exists within all of gynecology.
Their training covers:
- advanced retroperitoneal anatomy
- multi‑organ dissection and reconstruction
- complex adhesions and frozen pelvis cases
- safe mobilization of the bowel and ureters
- management of emergencies or difficult revision surgeries
This makes gynecologic oncologists uniquely capable of handling cases where the disease turns out to be more widespread than expected. So although the name focuses on cancer, the skill set is extremely relevant — and often essential — for difficult endometriosis cases. You do not need to have cancer to benefit from that level of expertise.
Why This Matters for You: “Better to Have It, and Not Need It”
Many endometriosis surgeries look straightforward at first, but once you’re on the operating table, things can change quickly. If your surgeon encounters extensive disease — such as deep infiltrating endometriosis, organ involvement (bowel, bladder, ureters), dense scarring from prior procedures, or even a frozen pelvis — they must be able to address it immediately and safely. When they cannot, patients may face incomplete surgery, the need for a second operation, higher complication rates, or disruptions to anatomy that can affect long‑term outcomes.
A surgeon with the highest level of pelvic surgical training can adapt safely and effectively, even if your disease turns out to be far more extensive than expected. That’s why choosing a surgeon with maximal training is not about assuming your case will be severe — it’s about being fully prepared if it is.
“I Don’t Have Cancer… Shouldn’t I See a Regular GYN Surgeon?”
It is a natural question, and one that highlights how confusing specialty names in medicine can be, but the fact is that endometriosis behaves more like a complex infiltrative disease than a simple benign condition. It often affects multiple structures — including reproductive organs, the bladder, bowel, ligaments, nerves, and deeper compartments like the retroperitoneum — which is why it requires a surgeon who can navigate all of these areas confidently.
This is why the surgeons best trained to treat extensive pelvic disease — including endometriosis — are gynecologic oncologists. Regular gynecologists or minimally invasive surgeons are excellent for routine or straightforward cases, but when there’s risk of deeper disease, organ involvement, or significant scarring, the expertise of a highly trained pelvic surgeon becomes crucial because these scenarios demand advanced anatomical skill and multi‑organ surgical capability.
Why Lotus Endo Is Different
Many gynecologic oncologists do some endometriosis surgery, but at Lotus Endometriosis Institute, we offer something truly unique: Dr. Steven Vasilev, a gynecologic oncologist who devotes his surgical practice exclusively to endometriosis and adenomyosis.
That means his highest‑level surgical training is applied entirely toward treating endometriosis and adenomyosis. For over a decade, he hasn’t divided time between cancer care and benign gynecology — his full focus has been understanding and operating on the most complex patterns of endometriosis. Patients receive the full benefit of a surgeon whose expertise is both elite and highly specialized. Very few surgeons combine this level of training with such a dedicated clinical focus, which further distinguishes the care offered at Lotus.
Patients at Lotus benefit from a surgeon who is prepared for any level of complexity, deeply experienced with multi‑organ disease, and consistently precise in the most challenging cases — which is why many people travel nationally and internationally for care here.
The Takeaway for Patients
Choosing a surgeon for endometriosis isn’t about labels; it’s about capability and preparedness for every level of complexity, especially when the true extent of disease often isn’t known until surgery begins.
A surgeon with the highest level of pelvic surgical training:
- keeps you safer
- increases the chances of finishing the surgery in one operation
- protects vital organs
- preserves fertility when possible
- manages unexpected findings without hesitation
And when that surgeon uses those elite skills exclusively for endometriosis and adenomyosis — like Dr. Vasilev at Lotus — you receive a level of care that is both rare and exceptionally effective. If your goal is the best possible long-term outcome, choosing the most highly trained pelvic surgeon simply gives you the greatest margin of safety and the strongest likelihood of a comprehensive, durable result.
References
Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10(5):261–275.
Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat Rev Dis Primers. 2018;4(1):9.
Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–1799.
Nezhat C, Vang N, Tanaka PP, Nezhat C. Optimal management of endometriosis and pain. Obstet Gynecol Clin North Am. 2010;37(3):403–413.
U.S. National Cancer Institute. Training in gynecologic oncology surgery (Fellowship standards).