Transvaginal natural orifice endoscopic surgery (vNOTES) for elderly patients

Area of Science:

• Gynecologic Surgery
• Minimally Invasive Procedures
• Geriatric Surgery

Background:

• Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) offers a minimally invasive approach.
• Evaluating vNOTES in elderly patients (70+) is crucial for expanding its application.
• Assessing feasibility and safety in this demographic is a key concern.

Purpose of the Study:

• To determine the feasibility and safety of vNOTES in patients aged 70 years and older.
• To evaluate surgical outcomes and complications in this specific patient population.
• To explore vNOTES as a viable treatment option for gynecologic pathologies in the elderly.

Main Methods:

• A prospective study involving eleven patients aged 70 and over who underwent vNOTES for gynecologic indications.
• Data collected included patient demographics, surgical details (operating time, blood loss, conversion rates), postoperative pain scores (VAS), and final pathology.
• Analysis focused on intra- and postoperative complications and overall success rates.

Main Results:

• vNOTES was performed safely and successfully in all eleven elderly patients.
• No intra- or postoperative complications or conversions to laparoscopy/laparotomy were observed.
• Pathology results included early-stage endometrioid adenocarcinoma, uterine leiomyoma, and other benign conditions, with no need for adjuvant therapy.

Conclusions:

• vNOTES is a safe and feasible surgical approach for treating gynecologic pathologies in elderly patients (70+).
• The procedure demonstrates excellent surgical outcomes and a favorable safety profile in this demographic.
• vNOTES represents a promising alternative to conventional minimally invasive surgeries for older adults.