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

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

doi:10.1186/s12905-024-03461-w

BMC Women's Health (Nov 2024)

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

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

Affiliations

Xian Wu: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Xin Li: West China Second University Hospital, Sichuan University
Aijie Xie: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Jia Liu: West China Second University Hospital, Sichuan University
Tianjiao Liu: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Yunyi Su: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Ying Liu: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Wei Cheng: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Ying Jin: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Lulu Wang: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Yujian Jia: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Jianmei Liao: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Hui Wang: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Xia Yu: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Ling Zhang: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Yalan Li: Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu
Li He: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Yonghong Lin: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Xiaoqin Gan: Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China

DOI: https://doi.org/10.1186/s12905-024-03461-w
Journal volume & issue: Vol. 24, no. 1
pp. 1 – 9

Abstract

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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.

Published in BMC Women's Health

ISSN: 1472-6874 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Gynecology and obstetrics; Medicine: Public aspects of medicine
Website: http://bmcwomenshealth.biomedcentral.com

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