History and current possibilities of vNOTES in gynecology

Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) represents a minimally invasive surgical approach that combines the principles of vaginal surgery and endoscopy, utilizing natural transvaginal access to the peritoneal cavity. This review aims to summarize the historical development of the vNOTES technique, its current indications, contraindications, safety, and clinical outcomes in benign gynecological surgery. Based on a systematic review of the available literature, current evidence suggests that vNOTES is comparable to laparoscopic approaches in terms of safety and perioperative complications in patients with benign gynecological conditions. Several studies have reported potential advantages of vNOTES, including reduced postoperative pain, shorter length of hospital stay, and faster recovery. However, the technique has certain limitations, particularly with regard to patient selection, technical complexity, and a relatively long learning curve. vNOTES appears to be a promising evolution of the vaginal surgical approach in benign gynecology, and its wider implementation requires appropriate surgical expertise and further high-quality clinical research.