Transvaginal natural orifice endoscopic surgery for hysterectomy: a prospective cohort study

• Published in: BMC women's health 2024-11, Vol.24 (1), p.631-9
• Main Authors: Wu, Xian, Li, Xin, Xie, Aijie, Liu, Jia, Liu, Tianjiao, Su, Yunyi, Liu, Ying, Cheng, Wei, Jin, Ying, Wang, Lulu, Jia, Yujian, Liao, Jianmei, Wang, Hui, Yu, Xia, Zhang, Ling, Li, Yalan, He, Li, Lin, Yonghong, Gan, Xiaoqin
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Bladder; Blood; Blood Loss, Surgical - statistics & numerical data; Care and treatment; Cervix; China; Cohort analysis; Diagnosis; Endoscopy; Enhanced recovery after surgery; Fallopian tubes; Female; Gynecological surgery; Health aspects; Health risks; Hemoglobin; Hospitals; Humans; Hysterectomy; Hysterectomy - methods; Hysterectomy, Vaginal - methods; Laparoscopes; Laparoscopy; Laparoscopy - methods; Length of Stay - statistics & numerical data; Ligaments; Middle Aged; Natural orifice endoscopic surgery; Natural Orifice Endoscopic Surgery - methods; Operative Time; Ovaries; Pain, Postoperative; Patient outcomes; Patients; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Prospective Studies; Prospective study; Quality of life; Recovery (Medical); Regression analysis; Surgeons; Sutures; Trauma; Uterus; Vagina; Vagina - surgery; Women
• ISSN: 1472-6874; 1472-6874
• DOI: 10.1186/s12905-024-03461-w

Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is widely recognized for its advantages, including reduced postoperative pain and the absence of visible scarring. However, the anatomical specificity required for vNOTES may increase the risk of injury to nearby organs, such as the rectum and bladder. This study aims to evaluate the safety and potential benefits of vNOTES compared to transumbilical laparoendoscopic single-site surgery (LESS) for Hysterectomy. The Longitudinal Vaginal Natural Orifice Transluminal Endoscopic Surgery Study (LovNOTESS), conducted in Chengdu, China, included 192 patients who underwent hysterectomy between May and October 2023. This study prospectively collected and compared perioperative and follow-up data between the two groups. The vNOTES group demonstrated shorter surgery times, postoperative flatus time, and hospital stays, but it also had a higher conversion rate. Specifically, the vNOTES approach reduced surgery duration by approximately 29.8 min (95% CI: -41.31, -18.34, P