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vNOTES for adnexal procedures.

Pedro Brandão1,2, Amélia Almeida3, Paula Ramôa4

  • 1Department of Reproductive Medicine, Instituto Valenciano de Infertilidad Plaza de la Policia Local 3, Valencia, Spain.

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
|April 1, 2021
PubMed
Summary
This summary is machine-generated.

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) offers a safe alternative for adnexal procedures. This minimally invasive technique resulted in good patient outcomes, minimal complications, and faster recovery compared to traditional laparoscopy.

Keywords:
Culdoscopynatural orifice endoscopic surgeryovarian cystectomysalpingo-oophorectomyvNOTES

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Area of Science:

  • Minimally Invasive Gynecologic Surgery
  • Natural Orifice Transluminal Endoscopic Surgery (NOTES)

Background:

  • Natural Orifice Transluminal Surgery (NOTES) aims to reduce complications compared to conventional laparoscopy.
  • Transvaginal NOTES (vNOTES) is an emerging technique for accessing the abdominal cavity through the vagina.

Purpose of the Study:

  • To describe the technique of vNOTES for adnexal procedures.
  • To review vNOTES adnexal surgeries performed.
  • To evaluate vNOTES as an alternative to conventional laparoscopy.

Main Methods:

  • vNOTES procedure involves a vaginal incision, single port insertion, laparoscopic surgery, vaginal specimen extraction, and vaginal apex closure.
  • Eighteen adnexal procedures were successfully completed using the vNOTES technique.

Main Results:

  • Successful completion of 18 vNOTES adnexal procedures.
  • One patient required conversion to laparoscopy due to pneumoperitoneum intolerance.
  • Procedures ranged from 45-210 minutes with minimal blood loss (<100 mL).
  • Patients experienced minimal pain, rapid discharge, no complications, and no dyspareunia.
  • Two patients achieved conception post-surgery.

Conclusions:

  • vNOTES is a safe and effective approach for adnexal procedures.
  • vNOTES presents a viable alternative to conventional laparoscopy and vaginal surgery.
  • Further research into vNOTES for more complex gynecologic procedures is warranted.