Vaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES) for Treating Benign Adnexal Diseases: Past Results and Future Developments

Evangelisti, Giulio; Barra, Fabio; Centurioni, Maria Grazia; D'Alessandro, Gloria; Alessandri, Franco; Ferrero, Simone

doi:10.1080/08941939.2020.1843205

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…Furthermore, the blood is constantly washed during the procedure to ensure clear vision. The postoperative residual blood volume in the abdominal cavity is significantly reduced, chemical irritation and inflammatory factors are reduced, and bowel function recovers faster (45)(46)(47).…”

Section: Discussionmentioning

confidence: 99%

Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Xie

Huang

et al. 2023

Front. Med.

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IntroductionAlthough previous studies have shown that vaginal natural orifice transluminal endoscopic surgery (vNOTES) has the advantages of causing less pain, faster recovery, and better concealment of surgical incisions, which aligns with the concept of the day-care procedure, this approach poses a greater risk of damaging adjacent organs (i. e., rectum and bladder) due to its anatomical specificity. Moreover, the day-care procedure may lead to relatively less preoperative evaluation and postoperative care. Hence, it is necessary to explore the safety and effectiveness of vNOTES for ovarian cystectomy in the day-care procedure, to provide a theoretical basis for the wider development of vNOTES surgery.Materials and methodsThis retrospective study included 131 patients at our hospital who underwent ovarian cystectomy from September 2021 to October 2022. Based on the surgical approach, patients were classified into transumbilical laparoendoscopic single-site surgery (LESS) and vNOTES groups. The patients' demographic characteristics and follow-up data were collected during the perioperative period and 1-month postoperatively.ResultsVaginal natural orifice transluminal endoscopic surgery has less postoperative exhaust time, a lower postoperative 6-hour pain score, and a lower incidence of analgesic drug use, with higher surgical conversion incidence. Multiple linear regression analysis showed that the surgical conversion, chocolate cyst, bilateral cyst, and pelvic adhesion increased the operation duration by ~43 (95% CI: 10.309, 68.152, p < 0.001), 15 (95% CI: 6.342, 45.961, p = 0.036), 10 (95% CI: 3.07, 40.166, p = 0.019), and 8 (95% CI: 4.555, 26.779, p = 0.035) min, respectively. Interestingly, vNOTES decreased the operation duration by ~8.5 min (95% CI: −18.313, −2.699, p = 0.033).ConclusionVaginal natural orifice transluminal endoscopic surgery was equally safe and effective for ovarian cystectomy compared to LESS. vNOTES aligned with the concept of the day-care procedure due to its reduced postoperative pain, shorter exhaust time, and absence of scarring. However, surgeons should conduct a comprehensive preoperative evaluation and exclude patients suspected to have severe pelvic adhesions.

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Section: Discussionmentioning

confidence: 99%

Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Xie

Huang

et al. 2023

Front. Med.

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“…In this study, we assessed the feasibility and safety of performing vNOTES for gynecological emergencies. This surgical approach has largely proven its worth for elective gynecological interventions such as hysterectomies and benign adnexal surgeries [6] , [7] , [8] , [9] , [11] , but limited data are currently available regarding its potential role in managing gynecological emergencies.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecological emergencies

Ferro,

Hurni,

Seidler

et al. 2023

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Hysterectomy via the vaginal route is not a new surgical technique in gynecology. However, with the emergence of minimally invasive surgery, vaginal surgery has been less frequently adopted in recent years due to poor visualization, limited surgical space, and the need for extensive surgical training [ 17 ]. Therefore, vNOTES hysterectomy was suggested to overcome the limitations of vaginal hysterectomy by utilizing laparoscopic instruments under an endoscopic view [ 18 ].…”

Section: Vnotes In Benign Gynecologic Conditionsmentioning

confidence: 99%

Clinical relevance of vaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecology

Kim,

Yim,

Kim

2024

Obstet Gynecol Sci

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This study reviews the progress and recent advances in vaginal natural orifice transluminal endoscopic surgery (vNOTES) as a minimally invasive gynecologic procedure. The proposed advantages of vaginal natural orifice transluminal surgery include enhanced cosmesis due to a scarless procedure, better exposure compared with the pure vaginal approach, tolerable pain scores, fewer perioperative complications, and a shorter hospital stay. Recent advances in surgical instrumentation and technology have improved the feasibility of vNOTES as an innovative treatment option for gynecological conditions. However, technical challenges and training issues must be overcome before its widespread use. As a promising surgical innovation, further randomized comparative studies are required to clarify the safety and effectiveness of vNOTES in gynecology.

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Vaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES) for Treating Benign Adnexal Diseases: Past Results and Future Developments

Cited by 5 publications

References 11 publications

Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecological emergencies

Clinical relevance of vaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecology

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