Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES): Feasibility of an innovative approach

Abstract

Hysterectomy for the treatment of benign diseases can be feasibly carried out via transvaginal NOTES. However, prospective studies are needed to determine its full clinical applications.

Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery for nonprolapsed uteri

“…The advantage of tVNO-TEH is the easier approach to the uterine vessels. As long as anterior and posterior colpotomies were created and home-made multichannel working port system was established, uterine vessels can be easily occluded by using vessel-sealed instrument under direct vision [10].…”

“…tVNOTEH technique Patient preparation, positioning, and anesthesia were the same as LAVH [11]. All operations were performed with a similar technique which is described earlier [10]. In brief, anterior and posterior colpotomies were created by using traditional vaginal surgical techniques.…”

“…At our institution, a tertiary referral medical center, gynecologic endoscopists have performed tubal sterilization, adnexal surgery, and hysterectomy by using the techniques of transvaginal NOTES since 2010 [9,10]. Although the successful removal of uterine weighting 538 g or more with transvaginal natural orifice transluminal endoscopic hysterectomy (tVNOTEH) was reported [10], however, the safety, feasibility, and outcomes of tVNOTEH have not been well established.…”

“…Although the successful removal of uterine weighting 538 g or more with transvaginal natural orifice transluminal endoscopic hysterectomy (tVNOTEH) was reported [10], however, the safety, feasibility, and outcomes of tVNOTEH have not been well established. The aim of this study was to compare the surgical outcomes, including operating time, EBL, complication, postoperative stay, and hospital charges between tVNOTEH and LAVH.…”

Natural orifice transluminal endoscopic surgery-assisted versus laparoscopic ovarian cystectomy (NAOC vs. LOC): a case-matched study

“…Purely transvaginal removal may encounter difficulty when the mass floated up beyond the uterine fundus and the semi-blind vision restricted the inspection of intraabdominal situation and assurance of complete hemostasis. Natural orifice transluminal endoscopic surgery (NOTES) has been the recent advancement in the gynecologic field of minimally invasive surgery [9][10][11][12][13]. This technique utilizes the posterior colpotomy as the surgical channel for endoscopic management of uterine and adnexal pathologies.…”