Hysterectomy Route and Numbers Reported by Graduating Residents in Obstetrics and Gynecology Training Programs

et al. 2020

BMC Surg

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 ≥1 kg, 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 min (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 ≥1 kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

BMC Surg

“…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%

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

et al. 2020

Preprint

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.

“…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 [3,7]. Several randomized trials and meta-analyses had shown that the minimally invasive approach (VH or LH) was clearly superior to AH in terms of perioperative outcomes and recovery time [8,9], and recommend VH as a feasible procedure for the patients with benign…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

Preprint

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.