Hysterectomy and Adenextomy via transvaginal natural orifice transluminal endoscopic surgery (vNOTES): A UK perspective with a case series of 33 patients

Karkia, Rebecca; Giacchino, Tara; Taylor, j Milo; Ghaffar, Ammara; Gupta, Abhishek; Kovoor, Elias

doi:10.1016/j.ejogrb.2019.08.023

Cited by 20 publications

(27 citation statements)

References 9 publications

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“…Hysterectomy is the most common surgical procedure in the domain of gynecology, and there are several surgical approaches to hysterectomy: abdominal hysterectomy (AH), vaginal hysterectomy (VH), laparoscopic hysterectomy (LH) with multi-port or single-port, robotic-assisted hysterectomy, and the emerging vNOTES hysterectomy [2,6]. Several randomized trials and meta-analyses have shown that the minimally invasive approach (VH or LH) is clearly superior to AH in terms of perioperative outcomes and recovery time [7,8], and recommend VH as a feasible procedure for the patients with benign indication and the LH as an alternative approach with the increased risk of urinary tract injury [8] .…”

Section: Discussionmentioning

confidence: 99%

“…The vNOTES combines conventional vaginal surgery and single-port laparoscopy as emerging technique, several studies revealed that vNOTES hysterectomy for benign could be feasible and safe approach, and has advantages over traditional laparoscopic and vaginal hysterectomy, such as low complications, minimal post-surgical pain, fast recovery and short hospitalization [2,10,11]. Currently, there was no publication about vNOTES hysterectomy in large uterus.…”

Section: Discussionmentioning

confidence: 99%

“…The previous publications have con rmed vNOTES to be a safe and feasible procedure for hysterectomy and adenextomy [2,3]. However, there were no literatures reported about vNOTES hysterectomy in large uterus, especially in uteri weighing ≥ 1 kilogram (kg).…”

Section: Introductionmentioning

confidence: 99%

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Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

Wang

Hua

et al. 2020

Preprint

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Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus ≥ 1 kilogram (kg). Methods: From January 2019 to March 2020, 39 patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patient demographics, indications for surgery, operation outcomes and patient follow-up details were recorded.Results: The mean age was 48 years (range 42-66); the mean BMI was 24 kg/m 2 (range 18.4-38); the mean operating time was 123.3 minutes (rang 40-400), mean estimated blood loss was 206.7 milliliters (range 10-1300); the mean uterus weight was 1141.8 gram (g) (range 1000-1720). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg. Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

Wang

Hua

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The vNOTES combined conventional vaginal surgery and single-port laparoscopy as emerging technique, several studies revealed that vNOTES hysterectomy for benign indications could be feasible and safe approach, and had advantages over traditional laparoscopic and vaginal hysterectomy, such as low complications, minimal post-surgical pain, fast recovery and short hospitalization [3,[11][12][13]. Currently, there was no publication about vNOTES hysterectomy in large uterus.…”

Section: Discussionmentioning

confidence: 99%

“…The previous publications have con rmed vNOTES to be a safe and feasible procedure for hysterectomy and adenextomy [3,4]. However, there were no literatures reported about vNOTES hysterectomy in large uterus, especially in uteri weighing ≥ 1 kilogram (kg).…”

Section: Introductionmentioning

confidence: 99%

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

Wang

Hua

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the vNOTES hysterectomy for uterus ≥ 1 kilogram (kg).Methods: From January 2019 to March 2020, patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patients’ demographics, indications for surgery, operation outcomes and follow-up details were recorded. Results: 39 patients were performed vNOTES hysterectomy for large uterus (mean weight 1141.8 gram, range from 1000 to 1720), indications for surgery included bulky uterine myomas or adenomysosis. The mean age was 48 years (range 42-66) and mean BMI was 24 kg/m2 (range 18.4-38). Mean operating time was 123.3 minutes (rang 40-400) and the mean estimated blood loss was 206.7 milliliters (range 10-1300). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg.Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.

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Evaluation of the learning curve and safety outcomes in robotic assisted vaginal natural orifice transluminal endoscopic hysterectomy: A case series of 84 patients

Liu

Tan

Thigpen

et al. 2022

Robotics Computer Surgery

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Background: To explore the learning curve and safety outcomes of robotic assisted transvaginal natural orifice transluminal endoscopic surgery (R-vNOTES) for hysterectomy in benign gynaecological diseases. Methods:A retrospective chart review of all patients undergoing R-vNOTES hysterectomy for benign gynaecological disease from 2019 to 2021.Setting: An academic tertiary care university hospital in Houston, TX, USA.Results: 84 patients were identified that met the study requirements. The mean hysterectomy time was 77.27 � 2.89 min. The median additional operation time was 63 (8-206) min. There were two conversions to robotic assisted single incision laparoscopy. Thirteen (15.48%) patients had an associated complication. Analysis of the learning curve suggests plateauing of hysterectomy time at approximately 10 cases and time for robot docking and port placement after 10-20 cases.Conclusion: R-vNOTES is a safe and effective route for hysterectomy. For a surgeon with experience in laparoscopic single site surgery and abdominal robotic surgery, they need to perform 10 cases of R-vNOTES hysterectomy and 10-20 cases in port placement and robotic docking to achieve proficiency.

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Hysterectomy and Adenextomy via transvaginal natural orifice transluminal endoscopic surgery (vNOTES): A UK perspective with a case series of 33 patients

Cited by 20 publications

References 9 publications

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

Evaluation of the learning curve and safety outcomes in robotic assisted vaginal natural orifice transluminal endoscopic hysterectomy: A case series of 84 patients

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