Diagnosing and Treating Infertility via Transvaginal Natural Orifice Transluminal Endoscopic Surgery versus Laparoendoscopic Single-Site Surgery: A Retrospective Study.

J Clin Med

Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, No. 2699, Gaoke West Road, Shanghai 200092, China.

Published: February 2023

Objective: To evaluate the efficacy and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in the treatment of female infertility.

Materials And Methods: This study includes 174 female patients with a history of long-standing female infertility. We retrospectively reviewed 41 patients who underwent hysterolaparoscopy (HL) via transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and 133 patients who underwent laparoendoscopic single-site surgery (LESS). Demographic data, operation records, and pregnancy outcomes were collected and analyzed. The deadline for postoperative follow-up was June 2022. All the included patients were followed up for at least 18 months after surgery.

Results: Compared with the LESS group, the vNOTES group had a shorter postoperative bowel movement time and less pain at 4 and 12 h ( = 0.004 vs. 0.008); no differences were found in other perioperative indicators. The clinical pregnancy rates of the vNOTES and LESS groups were 87.80% and 74.43% ( = 0.073), respectively.

Conclusions: vNOTES represents a new, less invasive approach for infertility diagnosis and treatment that is particularly suitable for women who have special esthetic requirements. vNOTES is safe and practical and may be an ideal choice for scarless infertility surgery.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9966021PMC
http://dx.doi.org/10.3390/jcm12041576DOI Listing

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  • The study details a modified transvaginal repair technique (V-NOTES) for treating apical vesicovaginal fistulas (VVFs) in 26 patients, with 17 undergoing the V-NOTES procedure between January 2020 and January 2023.
  • Outcomes showed an 88.2% success rate, with an average operative time of 104.2 minutes and minimal blood loss (10.45 ml).
  • No major complications arose, and even initially failed repairs were successful on subsequent attempts, indicating that V-NOTES is an effective and safe treatment option for apical VVFs.
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