Related Experiment Video
Updated: May 25, 2026
05:46
Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
Published on: January 17, 2019
Comparative Study of the Flipping Technique and Conventional Vaginal Natural Orifice Transluminal Endoscopic Surgery
Rihua Xu1, Ayijing Nurlan1, Hua Yao1
1Department of Gynecology, Karamay Center Hospital, Karamay, China.
Gynecologic and Obstetric Investigation
|May 23, 2026
Summary
The flipping technique in vaginal natural orifice transluminal endoscopic surgery (vNOTES) myomectomy effectively removes numerous, large, and fundal uterine fibroids. While increasing operative time and blood loss, it expands vNOTES indications with no abdominal scarring.
Area of Science:
- Minimally invasive gynecologic surgery
- Endoscopic surgical techniques
- Uterine fibroid management
Background:
- Vaginal natural orifice transluminal endoscopic surgery (vNOTES) offers scarless procedures.
- Conventional vNOTES myomectomy can be challenging for numerous, large, or fundally located fibroids.
- The flipping technique is a novel approach to enhance vNOTES myomectomy.
Purpose of the Study:
- To evaluate the clinical utility of the flipping technique in vNOTES myomectomy.
- To assess its effectiveness for difficult-to-expose uterine fibroids, especially at the fundus.
- To compare outcomes with conventional vNOTES myomectomy.
Main Methods:
- Retrospective analysis of 42 patients (flipping technique vNOTES) and 46 patients (conventional vNOTES).
- Comparison of preoperative, intraoperative, and postoperative clinical data.
- Data collected between January 2024 and May 2025 across two hospitals.
Main Results:
- Successful completion of all surgeries in both groups.
- Flipping technique group demonstrated larger uterine volumes and removal of more fibroids, including those at higher fundal positions.
- Flipping technique group experienced significantly longer operative times, increased blood loss, and delayed urinary catheter removal (p < 0.05).
Conclusions:
- The flipping technique in vNOTES myomectomy is advantageous for managing numerous, large, and fundally located fibroids.
- It offers scarless surgery and reduced postoperative pain compared to conventional vNOTES.
- This technique broadens the applicability of vNOTES myomectomy for complex fibroid cases.
