Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES): Feasibility of an innovative approach

TLDR

Prospective studies are needed to determine the full clinical applications of transvaginal NOTES hysterectomy. The study evaluates the feasibility and safety of transvaginal NOTES hysterectomy. Sixteen patients with benign uterine disease underwent transvaginal NOTES hysterectomy, with intraoperative and postoperative outcomes recorded. All 16 hysterectomies were completed without conversion, with mean uterine weight 538.8 g, operative time 122.7 min, blood loss 379.4 mL, average hospital stay 2.8 days, and no complications, demonstrating feasibility.

Abstract

To evaluate the feasibility and safety of performing a hysterectomy using the transvaginal natural orifice transluminal endoscopic surgery (NOTES). From May through December 2010, 16 patients with benign uterine diseases who were eligible for laparoscopic hysterectomy were recruited to undergo transvaginal NOTES at a tertiary referral medical center. Intraoperative and postoperative surgical outcomes were measured. All of the included hysterectomies were completed via transvaginal NOTES without conversion to conventional laparoscopy. The mean (± standard error of mean (SEM)) uterine weight was 538.8 ± 102.9 g, the mean operative time was 122.7 ± 17.6 minutes, and the mean blood loss was 379.4 ± 95.4 mL. The mean postoperative hospital stay was 2.8 ± 0.2 days. No intraoperative or postoperative complications were noted in this series. Hysterectomy for the treatment of benign diseases can be feasibly carried out via transvaginal NOTES. However, prospective studies are needed to determine its full clinical applications.