Natural Orifice Transluminal Endoscopic Surgery (NOTES) in Gynecology

Jallad, Karl; Walters, Mark D.

doi:10.1097/grf.0000000000000280

Cited by 20 publications

(18 citation statements)

References 28 publications

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“…The vaginal-incision gas leak is another inherent limitation of pure transvaginal NOTES due to a floppy and weak vaginal cuff. The gas leak of vaginal incision affects the outcomes of pure transvaginal NOTES performed under conventional pneumoperitoneum seriously [17]. The self-constructed vaginal glove port with wound retractor or a commercial port for laparoendoscopic single-site surgery alleviate gas leaks to some extent [3,18].…”

Section: Discussionmentioning

confidence: 99%

Transvaginal salpingo-oophorectomy with gasless laparoscopy — an optional pure natural orifice transluminal endoscopic surgery

Chen

Wang

2020

Ginekol Pol

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Objectives:To establish the appropriate technique for salpingo-oophorectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES), under gasless laparoscopy. Material and methods:Ten patients with clinical indication underwent gasless laparoscopic transvaginal salpingo-oophorectomy with concurrent vaginal hysterectomy. An abdominal-wall lifting device was used after removal of the uterus, and the adnexa was removed trans-vaginally by gasless laparoscopy. The perioperative clinical data, such as operative duration, volume of blood loss, morbidity, intraoperative and postoperative complications, and length of hospital stay, were retrospectively analyzed.Results: All procedures were successfully done, without any intraoperative or major postoperative complications, and no additional transabdominal ports were required. The salpingo-oophorectomy part of the procedure was completed in approximately 11-40 minutes, with minimal blood loss. All of the patients were discharged, scar-free, 2-4 days after surgery. Conclusions:Transvaginal NOTES with gasless laparoscopy is a feasible and safe surgical technique in cases involving difficult vaginal salpingo-oophorectomy, which avoids conversion to an abdominal route.

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Section: Discussionmentioning

confidence: 99%

Transvaginal salpingo-oophorectomy with gasless laparoscopy — an optional pure natural orifice transluminal endoscopic surgery

Chen

Wang

2020

Ginekol Pol

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“…NOTES is a scarless single-entry surgery, which is an emerging concept in minimally invasive techniques. Although it can be performed via various access routes such as the stomach, esophagus, vagina, bladder, and rectum, the vagina has been focused on almost exclusively, as it might be the safest and most feasible route for clinical application [33]. Reported advantages of NOTES include the absence of a visible abdominal scar, less operative pain, shorter hospital stay, improved operative visibility, and possibly, no requirement of adhesiolysis to expose the pelvic organs [33].…”

Section: Notes In Gynecologic Surgerymentioning

confidence: 99%

“…Although the use of NOTES in gynecologic surgery is rapidly increasing, technical difficulties that must be overcome still exist. As the limitation of NOTES is mainly related to collision between instruments, a study recommended using a flexible scope or a rigid scope with at least a 30-degree lens [33].…”

Section: Notes In Gynecologic Surgerymentioning

confidence: 99%

Recent advances in minimally invasive surgery for gynecologic indications

Koo¹

2018

Yeungnam Univ J Med

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Recently, an increasing interest in less invasive surgery has led to the advent of laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). LESS and NOTES could be technically challenging, but available literature has demonstrated the feasibility and safety of LESS for benign gynecologic diseases. However, the evidence is not strong enough to recommend the use of LESS over that of conventional multiport laparoscopic surgery (MLS). As per the results of the most recently published meta-analysis, the majority of surgical outcomes are equivalent between LESS and MLS, except for the longer operative time in LESS for both adnexal surgery and hysterectomy. Although an increasing number of studies have reported on robotic LESS, NOTES, and LESS for gynecologic malignancy, definite conclusions have not been drawn owing to the lack of sufficient information.

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“…Gynecologists have become increasingly interested in NOTES for these reasons, as well as for its ability to be applied to many gynecologic surgeries such as hysterectomy, adnexectomy, ovarian cystectomy, and myomectomy 3 . Additionally, recent case series have examined the use of NOTES in urogynecologic operations 4,5 …”

Section: Introductionmentioning

confidence: 99%

Apical pelvic organ prolapse repair via vaginal‐assisted natural orifice transluminal endoscopic surgery: Initial experience from a tertiary care hospital

Alay

Kaya

Cengiz

et al. 2020

Asian J Endoscop Surgery

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Introduction Natural orifice transluminal endoscopic surgery has been used for gynecologic operations in recent years. The aim of the study is to describe our initial experience using vaginal‐assisted natural orifice transluminal endoscopic surgery (vNOTES) for apical pelvic organ prolapse repair. Methods After patients underwent vaginal hysterectomy, vNOTES sacrocolpopexy (n = 4) or vNOTES high uterosacral ligament suspension (n = 7) were performed to treat symptomatic apical pelvic organ prolapse. Sociodemographic and clinical characteristics, Pelvic Organ Prolapse Quantification results, and recorded surgical data (eg, duration of surgery, intraoperative complications, additional prolapse and incontinence surgeries) were obtained from patient files and the hospital's database. Information from postoperative follow‐up visits, including complications and anatomical results, were also recorded. Results The mean age of the patients was 60.7 ± 9.1 years. The mean total operative time was 121.3 ± 22.7 minutes. The mean operative time for vaginal hysterectomy, vNOTES sacrocolpopexy, and vNOTES uterosacral ligament suspension was 46 ± 11.9, 65 ± 38, 25 ± 8.2 minutes, respectively. There were no intraoperative and postoperative complications observed. The mean postoperative 24‐hour visual analog scale score was 3.5 ± 1.9 for vNOTES sacrocolpopexy patients and 3.2 ± 0.9 for vNOTES uterosacral ligament suspension patients. Only one patient in the vNOTES sacrocolpopexy group had a recurrence; she experienced stage 2 anterior compartment prolapse 8 months after surgery. Conclusion As a treatment for apical pelvic organ prolapse, vNOTES is a feasible approach in both sacrocolpopexy and uterosacral ligament suspension.

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Natural Orifice Transluminal Endoscopic Surgery (NOTES) in Gynecology

Cited by 20 publications

References 28 publications

Transvaginal salpingo-oophorectomy with gasless laparoscopy — an optional pure natural orifice transluminal endoscopic surgery

Transvaginal salpingo-oophorectomy with gasless laparoscopy — an optional pure natural orifice transluminal endoscopic surgery

Recent advances in minimally invasive surgery for gynecologic indications

Apical pelvic organ prolapse repair via vaginal‐assisted natural orifice transluminal endoscopic surgery: Initial experience from a tertiary care hospital

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