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Related Concept Videos

Uterus and Cervix01:18

Uterus and Cervix

The uterus, commonly called the womb, is a vital reproductive organ in females designed to provide a nurturing environment for the implantation and growth of an embryo. It is shaped like a hollow pear and positioned between the urinary bladder and the rectum. The uterus's structure allows it to support and protect a developing fetus throughout pregnancy.
The uterus is securely anchored within the pelvic cavity by paired broad ligaments on either side. It is further stabilized by three pairs of...

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Prediction model and novel classification system for complications after minimally invasive hysterectomy.

Gynecologic and obstetric investigation·2026
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Risk factors for postoperative opioid prescription after benign hysterectomy.

European journal of obstetrics & gynecology and reproductive biology: X·2026
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A Global Consensus Conference on Surgical Management of Primary Uterovaginal Prolapse and Lower Urinary Tract Dysfunction: Combining Evidence with Expert Opinion.

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ADNOLA trial: a study-protocol - a randomised controlled trial study comparing adnexal surgery by vNOTES or laparoscopy.

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Recommendations for the treatment of endometrial cancer in settings with limited resources: report from the International Gynecological Cancer Society consensus meeting.

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Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
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vNOTES sentinel nodes removal from a remaining cervix.

Levon Badiglian-Filho1, Alexander Burnett2, Luka Matak3

  • 1Department of Gynecologic Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil.

Journal of Gynecology Obstetrics and Human Reproduction
|April 16, 2026
PubMed
Summary

Sentinel lymph node biopsy is feasible using the vaginal Natural Orifices Transluminal Endoscopic Surgery (vNOTES) approach, even after subtotal hysterectomy. This technique effectively identifies sentinel nodes by injecting ICG into the cervix.

Keywords:
Endometrial cancerIndocyanine green (ICG)OmentectomySentinel lymph nodeSubtotal hysterectomyvNOTES

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Area of Science:

  • Gynecologic Oncology
  • Minimally Invasive Surgery
  • Surgical Innovation

Background:

  • Sentinel lymph node biopsy is crucial for staging gynecologic malignancies.
  • vNOTES (vaginal Natural Orifices Transluminal Endoscopic Surgery) offers a minimally invasive surgical approach.
  • Previous subtotal hysterectomy presents challenges for traditional sentinel lymph node identification.

Purpose of the Study:

  • To demonstrate the feasibility of sentinel lymph node identification using vNOTES after subtotal hysterectomy.
  • To evaluate the efficacy of cervical Indocyanine Green (ICG) injection for sentinel node localization.

Main Methods:

  • Patients underwent subtotal hysterectomy for malignant neoplasia.
  • ICG was injected into the cervix for sentinel node mapping.
  • vNOTES approach was utilized for bilateral sentinel lymph node excision.
  • Surgical procedure included cervical removal, omentectomy, ureter identification, and adhesion biopsy.

Main Results:

  • Sentinel lymph nodes were successfully identified and excised using the vNOTES approach.
  • The absence of the uterine corpus did not impede sentinel lymph node detection via cervical ICG injection.
  • The technique proved effective in patients with a history of subtotal hysterectomy.

Conclusions:

  • The sentinel lymph node technique is feasible and effective in patients who have previously undergone subtotal hysterectomy.
  • vNOTES provides a viable minimally invasive pathway for performing sentinel lymph node biopsy in this patient population.