Postoperative outcomes and quality of life following hysterectomy by natural orifice transluminal endoscopic surgery (NOTES) compared to laparoscopy in women with a non-prolapsed uterus and benign gynaecological disease: a systematic review and meta-analysis

Baekelandt, Jan; Mulder, Peter A. De; Roy, Ilse Le; Mathieu, Chantal; Laenen, Annouschka; Enzlin, Paul; Weyers, Steven; Mol, Ben Willem J.; Bosteels, Jan

doi:10.1016/j.ejogrb.2016.10.044

Cited by 48 publications

(46 citation statements)

References 21 publications

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“…There were no differences between the techniques in complications, VAS pain scores at 12 hours, and additional requests for analgesics. There were no data on quality of life, sexual well‐being or dyspareunia …”

Section: Discussionmentioning

confidence: 99%

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

127

170

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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: Discussionmentioning

confidence: 99%

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

127

170

View full text Add to dashboard Cite

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“…Minimally invasive surgery is valuable not only because it provides improved cosmetic outcomes, but also because it results in minimal surgical injury. Performing hysterectomy by using natural orifice transluminal endoscopic surgery (NOTES) is advantageous because it does not result in a surgery scar; moreover, the feasibility and safety of NOTES hysterectomy have already been proven in several studies [ 1 2 3 4 5 ]. In study of 16 patients recruited between May and December 2010 in Taiwan, Su et al [ 1 ] concluded that transvaginal NOTES has acceptable feasibility and safety for the treatment of benign uterine diseases.…”

Section: Introductionmentioning

confidence: 99%

Postoperative outcomes of natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy and conventional laparoscopic-assisted vaginal hysterectomy: a comparative study

et al. 2018

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ObjectiveThe present study aimed to determine the differences in outcomes between natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy (NAVH) and conventional laparoscopy-assisted vaginal hysterectomy (LAVH).MethodsWe retrospectively reviewed the charts of patients who between July 2012 and September 2015, were diagnosed as having benign uterine disease such as uterine myoma, endometriosis, or adenomyosis and managed via NAVH or LAVH in a single-center (Eulji University Hospital). Data such as age, body weight, height, parity, operation time, intra/post-operative complications, and uterus weight were obtained from the clinical charts. NAVH and LAVH recipients were matched 1:3 in terms of baseline characteristics, and the 2 groups were compared regarding surgical outcomes.ResultsOf the 160 patients with benign uterine disease included in the present study. Forty received NAVH and remaining 120 received LAVH. There were significant differences between the groups regarding operation time and hemoglobin change. Notably, although the operation time was shorter for LAVH, hemoglobin change was lower for NAVH. Additionally, although maximum hospitalization duration was shorter for LAVH, the average length of hospitalization was similar between NAVH and LAVH. There were no significant differences between the groups in terms of other variables.ConclusionNAVH may become a new alternative surgical method of choice for hysterectomy, as it represents a clinically feasible and safe approach; moreover is superior to LAVH in terms of bleeding loss.

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“…Meta-analysis revealed that there were no statistically significant differences for intraoperative complications in women treated by NOTES compared to laparoscopy-assisted vaginal hysterectomy, we believe that this is because of the exclusion criteria for NOTES surgery [ 6 ]. Direct vision of the vaginal cuff inside the abdominal cavity after closure is one of the advantages of umbilical camera assisted V-NOTES.…”

Section: Discussionmentioning

confidence: 99%

“…NOTES was first performed in 2004 in aporcine model by researchers at the Johns Hopkins University [ 3 ]. Although the NOTES procedure has been applied in the field of general surgery since 2007 and has mostly used the vagina as the access route, the first hysterectomy using the NOTES procedure was done by Su et al in 2012 [ [4] , [5] , [6] ]. During the past decade, minimal invasive surgeries, including NOTES, have become popular, and most surgeons have begun using these procedures [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Hysterectomy and salpingo-oophorectomy by transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) assisted by an umbilical camera: Case report and new hybrid technique in gynecology

Terzi

Türkay

Uzun

et al. 2018

International Journal of Surgery Case Reports

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Postoperative outcomes and quality of life following hysterectomy by natural orifice transluminal endoscopic surgery (NOTES) compared to laparoscopy in women with a non-prolapsed uterus and benign gynaecological disease: a systematic review and meta-analysis

Cited by 48 publications

References 21 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

Postoperative outcomes of natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy and conventional laparoscopic-assisted vaginal hysterectomy: a comparative study

Hysterectomy and salpingo-oophorectomy by transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) assisted by an umbilical camera: Case report and new hybrid technique in gynecology

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