Victoria Vargas

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Victoria Vargas

Endometriosis Surgeon who believes in treating the whole disease

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Overview

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Most people who find Dr. Vargas have already seen multiple providers. They have had ultrasounds that came back normal, laparoscopies that found nothing, or surgeries that provided temporary relief before symptoms returned. What those evaluations often missed was not the absence of disease. It was the depth of it.

Endometriosis that infiltrates the bowel, bladder, diaphragm, or pelvic nerves does not reliably appear on standard imaging. It requires a surgeon who knows where to look before the patient is ever in the OR. Dr. Vargas has developed advanced skills with  pre-operative ultrasound mapping over the past 10 years with the focus of optimizing outcomes of complex endometriosis surgery. She offers ultrasound mapping to every surgical patient. The diagnostic framework she uses is used by specialist centers internationally and defines the location, depth, and extent of disease before surgery begins. It changes what the surgeon plans for, what specialists join the case, and what is possible once the OR team is assembled. 

Dr. Vargas completed her residency in obstetrics and gynecology at the Harvard Medical School Brigham and Women’s and Massachusetts General Hospitals, then pursued fellowship training in Minimally Invasive Gynecologic Surgery at George Washington University under Dr. James Robinson and Dr. Gaby Moawad. She later served as Chief of Minimally Invasive Gynecologic Surgery for Johns Hopkins Medicine in the National Capital Region, where she developed the endometriosis program. Her focus throughout has been the cases that require advanced skill, beyond what a general gynecologist can offer: deeply infiltrating endometriosis involving multiple organ systems, recurrent disease after previous surgery, and patients whose symptoms have never been fully explained.

She co-founded WECS because the surgical environment most endometriosis patients need does not exist in a standard gynecology practice. Excision surgery performed by a fellowship-trained surgeon, pre-operative mapping that defines disease before incision, and collaboration with colorectal, urology, and thoracic surgery already in the room when the anatomy requires it. That is the practice she built.



Online Consult Available?
Yes

At a glance

Gender
Female
Education
Residency
Obstetrics and Gynecology 2014
Harvard Medical School
Brigham and Women’s / Massachusetts General Hospital

Fellowship
Minimally Invasive Gynecologic Surgery (AAGL) 2016
The George Washington University

Medical Degree
Doctor of Medicine 2010
The George Washington University

Graduate Degree
Master of Science in Clinical and Translational Research 2016
The George Washington University
Affiliations
Washington Endometriosois and Complex Surgery
I completed my Endometriosis Fellowship under ___________
James Robinson and Gaby Moawad
Awards & Recognitions
Former President of the AAGL Endometriosis Special Interest Group

Course chair and invited instructor educator in a number of courses on the topic of advancing the care of endometriosis for AAGL, European Society of Gynaecological Endoscopy, and Society of Endometriosis and Uterine Disorders.

Invited speaker for Woman's Health Advocates and Endo Excision for All.

Co-founder of the Endometriosis Research Program
Insurance Accepted
WECS providers are out of network with insurance. This impacts patients in different ways depending on their insurance status:
- If you have out of network insurance benefits, we will submit bills directly to your insurance on your behalf. We will work with your insurance to ensure that they cover as much of your care with us as possible. The hospitals where we perform surgery and their anesthesiologists, pathologists, radiologists etc. are in network with most insurance carriers.
- For patients without out of network benefits, we can attempt to negotiate with your insurance company for an exception in some cases. If this is not possible or not approved by the insurance company, we will collect payment directly from you at the time of your consultation and at the time of surgical scheduling.
- The hospitals where we perform surgery and their anesthesiologists, pathologists, radiologists etc. are in network with most insurance carriers.

Endometriosis Surgeon Questionnaire

What percentage of your patients have endometriosis?
95
Do you practice obstetrics?
No
In 40 words or less, how do you treat endometriosis? How do you approach adhesions?
I perform surgery for endometriosis. My office offers non-surgical treatments for patients who choose this or who can’t undergo surgery. Adhesions indicate underlying endometriosis. I excise the endometriosis and use hemostatic agents and adhesion barriers to prevent scarring from surgery.
If you excise endometriosis, what is your goal for a sufficient margin size? If you use other methods of removing or destroying endometriosis, how do you approach this and under which circumstances?
I perform excision complete excision of all visible lesions with a normal tissue margin whenever possible and safe. I will offer sclerotherapy and hope to offer CO2 vaporization in the future, for endometriomas when a cystectomy could be too aggressive from a fertility standpoint.
On the scale of 1 (less experienced (I rarely treat/ mostly refer out)) to 5 (extremely experienced (the majority of my cases)) how would you rate your current experience level and comfort with stage 3/4 endometriosis and complex cases?
5
What is your opinion regarding GnRH agonists and antagonists? What is your opinion regarding hysterectomies?
I do not regularly recommend GnRH agonists and antagonists. There are some specific situations where they may be of benefit, such as patients undergoing fertility treatments with diagnosed adenomyosis or patients with very enlarged uteri who are undergoing a hysterectomy (to increase the safety of surgery). I perform hysterectomy for uterine disorders such as adenomyosis or fibroids when a patient makes that choice.
What is your opinion on using Robotics (ie DaVinci) for the treatment of endometriosis? Do you use it?
I use robotic surgery.
Do you work with and/or refer patients to other healthcare providers? If so, which types (e.g. physical therapists, nutritionists, etc.) ?
Physical therapists
Nutritionists
Integrative medicine
Physical Medicine and Rehabilitation
Acupuncture
Massage
Meditation centers
How do you approach the following: bowel cases, urinary cases, thoracic cases and any other extragenital cases?
Identifying complex endometriosis prior to surgery is possible via both ultrasound and MRI. I have a rigorous pre-operative identification process that allows me to counsel my patients thoroughly and surgically prepare for deep infiltrating endometriosis involving multiple organ systems. I regularly perform advanced endometriosis surgery that involves the bowel, bladder, ureter, diaphragm and abdominal wall among other complex presentations of endometriosis. I perform about 2-3 complex cases per week. I work with a colorectal surgeon, urologist, thoracic and abdominal wall surgeon when cases are extremely complex and require this approach. I discuss this with the patient prior to surgery and the patient meets the collaborator before surgery. I remain present for all parts of the case to ensure all visible lesions have been removed. I believe that patients benefit immensely from pre-operative mapping and a collaborative surgical approach, giving them the best chance of a complete excision of their disease.
Do you follow up with patients at regular intervals post-operatively? If so, what are your findings?
I see patients at 4 and 12 weeks post-operatively and offer long term follow-up through a nurse practitioner in my practice. Patients have great surgical outcomes and pain/QoL outcomes because this collaborative approach allows us to combine a complete excision with management of overlapping pain generators. Our approach allows patients to maximize the benefits of a complete surgical excision of endometriosis and reduce the risk of unnecessary re-operation.
What percentage of your patients require re-surgery? How do you track this?
5-15% due to recurrent disease. Tracking has just started via a database, however, this has been my general experience over the years.
Do you have any studies, talks, or publications you'd like to share?
Yes
If you'd like to share any of your work online, please link to it here
What are some fun facts about you? Hobbies, interests, family life, languages, etc. that you would like to share to help patients get to know you as a person?
I am an avid yogi, runner, and gardener. I love music of all kinds and need it in my OR to create the environment for surgery to flow smoothly. I love a good adventure and am willing to try most things at least once. My favorite things to do outside of work and family time are laugh, eat, and sleep.

Location

5225 Wisconsin Avenue NW Suite 513, Washington, DC, USA

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