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Published on: January 17, 2019
The Introduction of the vNOTES Hysterectomy in The Netherlands: A Nationwide Cohort Study
Hilde M M Sluijter1, Ilse P W Bekkers2,3, Rebecca Henschen2,3
1Department of Gynaecology and Obstetrics, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
Objective:
This study aims to assess the peri- and postoperative outcomes of the vNOTES hysterectomy in the Netherlands during implementation.
Study Design:
Nationwide cohort study.
Setting:
vNOTES hysterectomies performed in the Netherlands by 15 hospitals since the implementation of the technique, from August 2019 to September 2024.
Population:
673 patients undergoing vNOTES hysterectomy.
Methods:
Descriptive data are presented as frequencies with percentage or mean with range. Logistic regression was used to assess the risk of conversions/complications per BMI group.
Main Outcome Measures:
Peri- and postoperative outcomes such as operating time, conversions, and complications.
Results:
The mean operating time was 67.4 min (range 24-210). There were 37 (5.5%) conversions and 94 (15.5%) complications. Nineteen (2.8%) complications were perioperative, and 75 (12.7%) postoperative. Ten (1.5%) of the perioperative complications were classified as Clavien-Dindo (CD) 1, and nine (1.3%) as CD3. Postoperatively, 18 patients (3.1%) had a reintervention (N = 17 CD3, N = 1 CD4), and two (0.3%) patients were admitted to the intensive care unit (CD4). The mean blood loss was 127 mL (range 50-2000), and 220 (37%) of patients were discharged the same day.
Conclusions:
This large nationwide cohort study during implementation of the vNOTES hysterectomy demonstrates the safety and feasibility of this upcoming technique, reporting on a short surgery duration and a similar complication percentage compared to other methods of hysterectomy.
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