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Updated: Feb 28, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Transvaginal endoscopic surgery-assisted versus conventional laparoscopic adnexectomy (TVEA vs. CLA): A
Yi-Chieh Li1, Fei-Chun Ku1, Hsin-Hong Kuo1
1Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan.
Objective:
Natural orifice transluminal endoscopic surgery (NOTES) may be useful in gynecologic endoscopic surgery. This study evaluated the efficacy, safety, and perioperative outcomes of combined NOTES and vaginal approach, transvaginal endoscopic surgery-assisted adnexectomy (TVEA), for the surgical treatment of presumed benign ovarian tumors.
Materials And Methods:
Records were reviewed for 33 consecutive TVEA procedures performed between May 2011 and March 2014. Patient age, body mass index, parity, mass size, and mass bilaterality were used to select comparable patients who had undergone conventional laparoscopic adnexectomy (CLA).
Results:
A total of 236 patients were included in this study (203 CLAs and 33 TVEAs). No cases switched to abdominal laparotomy. Operating time and length of postoperative stay were significantly longer in the CLA group than in the TVEA group, while total hospital charges were higher in the TVEA group (p < 0.001). There was no difference in febrile morbidity between the two groups; while the estimated blood loss was higher in the TVEA group, the EBL was <30 mL in both groups.
Conclusion:
TVEA can be safely performed for benign and large ovarian tumors. In addition, TVEA offers superior operative efficiency compared to CLA.
