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BMC Women's Health
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Open Access 01-12-2024 | Hysterectomy | Research

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

Authors: Xian Wu, Xin Li, Aijie Xie, Jia Liu, Tianjiao Liu, Yunyi Su, Ying Liu, Wei Cheng, Ying Jin, Lulu Wang, Yujian Jia, Jianmei Liao, Hui Wang, Xia Yu, Ling Zhang, Yalan Li, Li He, Yonghong Lin, Xiaoqin Gan

Published in: BMC Women's Health | Issue 1/2024

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Abstract

Objective

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.

Methods

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.

Results

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 < 0.001) but increased intraoperative blood loss by about 41.82 mL (95% CI: 25.81, 57.82, P < 0.001).

Conclusion

By combining laparoscopy with traditional vaginal surgery, vNOTES offers advantages such as shorter surgery times, faster postoperative recovery, reduced hospital stays, greater minimal invasiveness, and improved cosmetic outcomes. However, it is essential for surgeons to continually enhance and standardize preoperative assessments and surgical techniques to minimize conversion rates and reduce intraoperative blood loss.

Trial registry number

ChiCTR2200059282, China Clinical Trials Registry, April 28, 2022.
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Metadata
Title
Transvaginal natural orifice endoscopic surgery for hysterectomy: a prospective cohort study
Authors
Xian Wu
Xin Li
Aijie Xie
Jia Liu
Tianjiao Liu
Yunyi Su
Ying Liu
Wei Cheng
Ying Jin
Lulu Wang
Yujian Jia
Jianmei Liao
Hui Wang
Xia Yu
Ling Zhang
Yalan Li
Li He
Yonghong Lin
Xiaoqin Gan
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Hysterectomy
Published in
BMC Women's Health / Issue 1/2024
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-024-03461-w

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