Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery for nonprolapsed uteri

Wang, Chin‐Jung; Huang, Hui‐Yu; Huang, Chung-Yuan; Su, Hsuan

doi:10.1007/s00464-014-3639-y

Cited by 59 publications

(79 citation statements)

References 24 publications

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“…The findings of a shorter length of hospital stay with vNOTES are consistent with the findings of a systematic review and meta‐analysis including two observational studies . Based on the findings of that systematic review, length of hospital stay was shorter with vNOTES than with LAVH.…”

Section: Discussionsupporting

confidence: 86%

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Baekelandt

Mulder

Roy

et al. 2018

BJOG

126

150

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Objective To compare hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) versus total laparoscopic hysterectomy (TLH) as a day-care procedure.Design Parallel group, 1:1 randomised single-centre single-blinded trial, designed as a non-inferiority study with a margin of 15%.Setting Belgian teaching hospital.Population Women aged 18-70 years scheduled to undergo hysterectomy for benign indications.Methods Randomisation to TLH (control group) or vNOTES (experimental group). Stratification according to uterine volume. Blinding of participants and outcome assessors.Main outcome measures The primary outcome was hysterectomy by the allocated technique. We measured the proportion of women leaving within 12 hours after hysterectomy and the length of hospital stay as secondary outcomes. Results We randomly assigned 70 women to vNOTES (n = 35) or TLH (n = 35). The primary endpoint was always reached in both groups: there were no conversions. We performed a sensitivity analysis for the primary outcome, assuming one conversion in the vNOTES group and no conversions in the TLH group: the onesided 95% upper limit for the differences in proportions of conversion was estimated as 7.5%, which is below the predefined non-inferiority margin. More women left the hospital within 12 hours after surgery after vNOTES: 77 versus 43%, difference 34% (95% CI 13-56%), P = 0.007. The hospital stay was shorter after vNOTES: 0.8 versus 1.3 days, mean difference À0.5 days, (95% CI À0.98 to À0.02), P = 0.004.Conclusions vNOTES is non-inferior to TLH for successfully performing hysterectomy without conversion. Compared with TLH, vNOTES may allow more women to be treated in a day-care setting.Keywords Core outcome set, day-care surgery, laparoscopic hysterectomy, randomised controlled trial, vNOTES.Tweetable abstract RCT: vNOTES is just as good as laparoscopy for successful hysterectomy without conversion but allows more day-care surgery.Please cite this paper as: Baekelandt JF, De Mulder PA, Le Roy I, Mathieu C, Laenen A, Enzlin P, Weyers S, Mol BWJ, Bosteels JJA. Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day-care procedure: a randomised controlled trial. BJOG 2019;126:105-113.

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Section: Discussionsupporting

confidence: 86%

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Baekelandt

Mulder

Roy

et al. 2018

BJOG

126

150

View full text Add to dashboard Cite

show abstract

“…Interestingly, the mean operative time, amount of blood loss, and postoperative hospital stay resulted significantly inferior in the NOTES group, regardless of uterine weight. Although there was no difference in the overall incidence of operative complications between the two groups, there were more complications in the LAVH group for uterine weight more than 500 g [8].…”

mentioning

confidence: 65%

Natural Orifice Transluminal Endoscopic Surgery (NOTES): Landscape of Current Experimental Applications in Gynecological Surgery

Barra

Alessandri

Evangelisti

et al. 2020

Journal of Investigative Surgery

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“…Furthermore, the uterine weight did not substantially affect the main surgery console time. Although a previous study on laparoscopic hysterectomy reported a positive correlation between the uterine weight and operation time [12], a recent study by Silasi et al [13] demonstrated that increasing uterine size does not proportionally affect the operation time in robotic or abdominal hysterectomy. In minimally invasive hysterectomies, most surgeons have to morcellate the large uterus into small pieces to facilitate its removal from the abdominal cavity, which is typically time consuming.…”

Section: Discussionmentioning

confidence: 99%

Learning Curve Analysis of Different Stages of Robotic-Assisted Laparoscopic Hysterectomy

Tang

Tsai

2017

BioMed Research International

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Objective. To analyze the learning curves of the different stages of robotic-assisted laparoscopic hysterectomy. Design. Retrospective analysis. Design Classification. Canadian Task Force classification II-2. Setting. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Patient Intervention. Women receiving robotic-assisted total and subtotal laparoscopic hysterectomies for benign conditions from May 1, 2013, to August 31, 2015. Measurements and Main Results. The mean age, body mass index (BMI), and uterine weight were 46.44 ± 5.31 years, 23.97 ± 4.75 kg/m2, and 435.48 ± 250.62 g, respectively. The most rapid learning curve was obtained for the main surgery console stage; eight experiences were required to achieve duration stability, and the time spent in this stage did not violate the control rules. The docking stage required 14 experiences to achieve duration stability, and the suture stage was the most difficult to master, requiring 26 experiences. BMI did not considerably affect the duration of the three stages. The uterine weight and the presence of adhesion did not substantially affect the main surgery console time. Conclusion. Different stages of robotic-assisted laparoscopic hysterectomy have different learning curves. The main surgery console stage has the most rapid learning curve, whereas the suture stage has the slowest learning curve.

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Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery for nonprolapsed uteri

Abstract: tVNOTEH can be safely performed for large and nonprolapsed uterus. Besides, as uterine weight increased, the operative efficiency of tVNOTEH increases compared with LAVH.

Cited by 59 publications

References 24 publications

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Natural Orifice Transluminal Endoscopic Surgery (NOTES): Landscape of Current Experimental Applications in Gynecological Surgery

Learning Curve Analysis of Different Stages of Robotic-Assisted Laparoscopic Hysterectomy

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