Background: Natural orifice transluminal endoscopic surgery by the vaginal route (vNOTES) is a new approach to performing hysterectomy. Clinical outcomes must be evaluated in centres that have started performing this technique.
Objectives: To compare operative outcomes between vNOTES hysterectomy and laparoscopic hysterectomy during the introduction of the vNOTES approach in a teaching hospital.
Material And Methods: A retrospective study was conducted from November 2019 to May 2021 at a French academic hospital in Marseille. The included patients underwent total hysterectomy for benign indications by vNOTES or conventional laparoscopy.
Main Outcome Measures: Operative time, uterus weight, intraoperative complications, and postoperative complications according to the Clavien-Dindo classification.
Results: Eighty-six patients underwent hysterectomy according to the selected criteria: 36 procedures were performed by vNOTES and 50 by laparoscopy. The mean operative time was shorter in the vNOTES group than in the laparoscopy group [116 min versus 149 min; p=0.003]. The mean uterus weight was not different between the vNOTES group and the laparoscopy group (238g versus 281g; p=0.572). Laparo-conversion occurred in one case in the vNOTES group (2.7%) and three cases in the laparoscopy group (3.4%). One Grade III postoperative complication occurred in the laparoscopy group, and no severe complication occurred in the vNOTES group.
Conclusion: Operative outcomes of the vNOTES hysterectomy were favourable and support good feasibility without additional morbidity compared to laparoscopy.
What Is New?: During the introduction period of the vNOTES hysterectomy technique in a teaching hospital, reassuring operative outcomes and a low rate of complications were observed.
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| http://dx.doi.org/10.52054/FVVO.14.2.018 | DOI Listing |
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vNOTES as a salvage method for adnexectomy and high uterosacral ligament suspension after vaginal hysterectomy under epidural anesthesia: A feasibility and safety study.
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Department of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, 213000, People's Republic of China.
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A single center retrospective study of vNOTES hysterectomy, laparoscopic hysterectomy and vaginal hysterectomy operations.
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View Article and Find Full Text PDFTransvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) in Benign Gynaecology: A Systematic Review of Adnexal, Myomectomy and Prolapse Procedures.
J Minim Invasive Gynecol
December 2024
University of Sydney (Drs. Benton-Bryant and Kapurubandara), Sydney, New South Wales, Australia; Sydney West Area Pelvic Surgical Unit (SWAPS) (Drs. Pour and Kapurubandara), Sydney, New South Wales, Australia; Department of Obstetrics and Gynaecology, Westmead Hospital (Dr. Kapurubandara), Sydney, New South Wales, Australia.
Objective: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is utilised for gynecological procedures globally, however evidence to support its application aside from hysterectomy is lacking. A systematic review to determine feasibility and safety profile of vNOTES for benign gynaecology was conducted.
Data Sources: A literature search of MEDLINE, EMBASE, CINAHL, SCOPUS, and CENTRAL was conducted, including all types of studies reporting vNOTES for gynecological indications.
Transvaginal natural orifice endoscopic surgery for hysterectomy: a prospective cohort study.
BMC Womens Health
November 2024
Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, 1617 Riyue Avenue, Qingyang District, Chengdu, Sichuan, 611731, China.
Article Synopsis
- The study compares vaginal natural orifice transluminal endoscopic surgery (vNOTES) to transumbilical laparoendoscopic single-site surgery (LESS) for hysterectomy, focusing on safety and benefits.
- The research involved 192 patients in Chengdu, China, and found that vNOTES resulted in shorter surgery times and quicker recovery, but had a higher conversion rate and slightly increased blood loss.
- The conclusion emphasizes vNOTES advantages in minimal invasiveness and cosmetic results, while recommending improvements in surgical techniques to minimize risks associated with the approach.
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