Transvaginal natural orifice specimen extraction surgery in simple nephrectomy.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Gynecologic Surgery

Background:

• Natural orifice specimen extraction surgery (NOSES) is an emerging technique in laparoscopic urology.
• Transvaginal NOSES utilizes the vaginal route for specimen retrieval, offering potential benefits over traditional methods.

Purpose of the Study:

• To evaluate the feasibility, safety, and outcomes of transvaginal NOSES for laparoscopic simple nephrectomy in Indian women.
• To assess the impact on postoperative recovery, pain, and functional outcomes.

Main Methods:

• A prospective observational study included 15 women undergoing laparoscopic simple nephrectomy with transvaginal specimen extraction.
• Exclusion criteria focused on conditions that could complicate vaginal access or recovery.
• Key metrics included operative time, blood loss, recovery milestones, hospital stay, pain scores, and validated questionnaires for pelvic floor and sexual function.

Main Results:

• The procedure was successfully completed in all patients without conversion to open surgery.
• Average operative time was 127.8 minutes, with an average extraction time of 30.13 minutes.
• Patients experienced minimal blood loss (68.0 mL), rapid recovery (1 day for milestones), short hospital stays (2.2 days), and low pain scores. Postoperative pelvic floor and sexual function were preserved.

Conclusions:

• Transvaginal NOSES is a feasible and safe approach for laparoscopic simple nephrectomy.
• The technique is associated with reduced postoperative pain, minimal blood loss, and expedited recovery.
• Transvaginal NOSES demonstrates potential for improved surgical outcomes and patient satisfaction in select female populations.