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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016136PMC

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This study demonstrates the feasibility of performing a Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) hysterectomy on a patient with a complex surgical history, including two renal transplants. The case involves a 42-year-old female presenting with persistent menorrhagia and hypermenorrhea, unresponsive to standard treatments, and diagnosed with adenomyosis and CIN3. A detailed, step-by-step procedure of the vNOTES technique is provided, marking the first video article to document vNOTES hysterectomy in such a medical context.

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Objective: Recent advancements of minimally invasive gynecologic surgery have led to the development of transvaginal natural orifice translumenal endoscopic surgery (vNOTES) [1,2]. Robot-assisted vNOTES has also been explored as a method providing accurate and fine surgical procedures with improved ergonomics, visualization, wristed instruments, elimination of the hand tremor [3,4]. The objective of this video is to demonstrate the technical and anatomical highlights of a vaginal assisted NOTES hysterectomy (VANH) using the da Vinci SP (SP).

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