Transvaginal natural orifice transluminal endoscopic surgery for ectopic pregnancy

• Published in: The journal of obstetrics and gynaecology research 2022-03, Vol.48 (3), p.843-849
• Main Authors: Ozceltik, Gokay, Simsek, Deniz, Hortu, Ismet, Yeniel, Ahmet O., Itil, Ismail M.
• Format: Article
• Language: English
• Subjects: Cesarean Section; Complications; Ectopic pregnancy; Endoscopy; Female; Humans; Laparoscopy; minimally invasive surgery; Natural Orifice Endoscopic Surgery - adverse effects; Natural Orifice Endoscopic Surgery - methods; Patients; Postoperative; Pregnancy; Pregnancy complications; Pregnancy, Ectopic - surgery; Retrospective Studies; Surgery; transvaginal natural orifice transluminal endoscopic surgery; Vagina; Vagina - surgery; vNOTES
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.15165

Aims This study aims to describe our transvaginal natural orifice transluminal endoscopic surgery (vNOTES) technique for ectopic pregnancy that can be performed using conventional laparoscopic equipment with the addition of a self‐constructed pessary port and to evaluate the safety, feasibility, and outcomes of the technique. Methods This is a retrospective study evaluating outcomes of patients who underwent vNOTES for ectopic pregnancy (n = 21) between August 2019 and April 2021. Results Twenty‐one patients underwent vNOTES as intended without any intraoperative complications. Three patients (14.3%) were nulliparous, 16 patients (76.2%) had no history of vaginal delivery, and 13 patients (61.9%) had a history of at least one cesarean delivery. Eight patients (38.1%) had a history of previous abdominal surgery other than cesarean section. The mean duration of surgery was 43.4 ± 12.6 min. The mean visual analog scale scores for pain were 2.45 ± 1.13 at 2 h after surgery, 0.45 ± 0.83 at 12 h after surgery, and 0.18 ± 0.36 at 24 h after surgery. The median duration of postoperative hospital stay was 1 day (range, 1–2). There were no postoperative complications within 30 days after surgery. Conclusions vNOTES can be performed in an existing laparoscopy setup with the addition of a self‐constructed pessary port. vNOTES is a safe and effective surgical treatment option for ectopic pregnancy, even in patients who have not had a vaginal delivery and have had multiple abdominal surgeries.