Vaginal Natural Orifice Transluminal Endoscopic Surgery Hysterectomy Deconstructed: Expanding Minimally Invasive Gynecologic Surgeons' Toolbox

Veronica Lerner; Andrea E Stuart; Jan Baekalandt

doi:10.1089/gyn.2023.0098

Vaginal Natural Orifice Transluminal Endoscopic Surgery Hysterectomy Deconstructed: Expanding Minimally Invasive Gynecologic Surgeons' Toolbox

J Gynecol Surg. 2024 Apr 1;40(2):78-99. doi: 10.1089/gyn.2023.0098. Epub 2024 Apr 12.

Authors

Veronica Lerner¹, Andrea E Stuart^{2

3}, Jan Baekalandt⁴

Affiliations

¹ Department of Obstetrics & Gynecology, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, New York, USA.
² Department of Obstetrics and Gynaecology, Institution of Clinical Sciences, Lund University, Lund, Sweden.
³ Department of Obstetrics and Gynaecology, Helsingborg Hospital, Sweden.
⁴ Department of Gynaecologic Oncology, Imelda Hospital, Bonheiden, Belgium.

Abstract

Background: The introduction of vaginal natural orifice transluminal endoscopic surgery (vNOTES) to the toolbox of gynecologic surgeons has the potential to reverse the trend of vaginal hysterectomy declines.

Methods: This review discusses nuances of the vNOTES technique applied to hysterectomy; describes vNOTES hysterectomy, step-by-step (including tips and tricks for low- and high-complexity cases for surgeons who may want to incorporate vNOTES hysterectomy into their surgical repertoires); and examines evidence and research trends in this field.

Results: The descriptions in the text, figures, tables, and videos all contribute to giving readers a clear understanding of vNOTES, its advantages, limitations, and research potentials.

Conclusions: vNOTES hysterectomy is a unique blend of vaginal, laparoscopic, and laparoendoscopic single-site surgery (LESS) techniques and is not a new procedure, but rather another tool to use in minimally invasive gynecologic surgery. (J GYNECOL SURG 40:78).

Keywords: minimally invasive gynecologic surgery; minimally invasive hysterectomy; vNOTES hysterectomy; vaginal natural orifice transluminal endoscopic surgery.