Related Experiment Video
Updated: Jan 7, 2026
Transvaginal Mesh Insertion in the Ovine Model
Published on: July 27, 2017
Gasless transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for sacrospinous fixation: An
Gautier Chene1, Emanuele Cerruto2, Stephanie Moret2
1Department of Gynecology, Hôpital Femme Mère Enfant, HFME, 59 boulevard Pinel, University Hospital of Lyon, 69500 Bron, France; University Claude Bernard of Lyon 1, EMR 3738 CICLY, 69000 Lyon, France.
Objective:
Minimally invasive sacrospinous fixation is the gold standard procedure for management of apical pelvic organ prolapse. However, as it is a blind and palpatory technique, there may be a relevant risk of neurovascular injury due to the proximity of neurovascular structures. The vNOTES (transvaginal Natural Orifice Transluminal Endoscopic Surgery) approach is a surgical technique that appears promising in the management of pelvic organ prolapse. We propose an anatomical study concerning the vNOTES anterior sacrospinous fixation.
Study Design:
Bilateral gasless vNOTES anterior sacrospinous fixation was performed in two female cadavers without any synthetic mesh.
Results:
Identification of ischial spine and sacrospinous ligament as well as feasibility of gasless vNOTES sacrospinous fixation were always possible on both sides.
Conclusions:
The vNOTES sacrospinous fixation may be relevant and could be an advantage in terms of safety and better placement of the suture on the sacrospinous ligament thanks to endoscopic vision.
