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Review
. 2023 Jan-Mar;27(1):e2022.00082.
doi: 10.4293/JSLS.2022.00082.

Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution: The Next Frontier in Gynecologic Minimally Invasive Surgery

Veronica T Lerner  1 , Grover May  2 , Cheryl B Iglesia  3
Affiliations
Review

Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution: The Next Frontier in Gynecologic Minimally Invasive Surgery

Veronica T Lerner et al. JSLS. 2023 Jan-Mar.

Abstract

Despite guidelines that assert that the vaginal route for benign hysterectomy is preferred as the most minimally invasive approach, rates of vaginal hysterectomy remain very low in the United States. Vaginal natural orifice transluminal endoscopic surgery (vNOTES) might reverse the trend. Potential advantages of vNOTES compared to traditional laparoscopic and robotic approaches include the potential for less pain, decreased operative time, improved cosmesis, and decreased risks. Importantly, vNOTES might allow for the conversion of laparoscopic and robotic routes back to vaginal due to surgeon factors.

Keywords: Minimally invasive gynecologic surgery; Vaginal natural orifice transluminal endoscopic surgery; Vaginal surgery; vNOTES.

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Conflict of interest statement

Conflict of interests: none.

Figures

Figure 1.
Figure 1.
(A) Transabdominal multichannel commercially available single-site port (GelPOINTR Mini) (Applied Medical, Rancho Santa Margarita, CA) placed into the umbilicus. Obtained with permission from Applied Medical, Rancho Santa Margarita, California. (B) Transabdominal multichannel commercially available single-site port (GelPOINT Mini) placed into umbilicus with one additional assist port for laparoscopic myomectomy setup. Obtained with permission from Applied Medical, Rancho Santa Margarita, California. (C) Transabdominal multichannel commercially available single-site port (GelPOINTR Mini) (Applied Medical, Rancho Santa Margarita, CA) placed suprapubically in a multiport laparoscopic surgery setup for general surgery cases. Obtained with permission from Applied Medical, Rancho Santa Margarita, California.
Figure 2.
Figure 2.
Self-made two-channel single-site port.7
Figure 3.
Figure 3.
Self-constructed multichannel single-site port device for vaginal natural orifice transluminal endoscopic surgery. Courtesy of Jan Baekeland, MD.
Figure 4.
Figure 4.
Commercially available multichannel single-site port device for vaginal natural orifice transluminal endoscopic surgery (GelPOINTR V-Path). Obtained with permission from Applied Medical, Rancho Santa Margarita, California.
See this image and copyright information in PMC

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References

    1. Wright JD, Huang Y, Li AH, Melamed A, Hershman DL. Nationwide estimates of annual inpatient and outpatient hysterectomies performed in the United States. Obstet Gynecol. 2022;139(3):446–448. - PubMed
    1. Committee Opinion No. 701 Summary: Choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2017;129(6):1149–1150. - PubMed
    1. Moen M, Walter A, Harmanli O, et al. . Considerations to improve the evidence-based use of vaginal hysterectomy in benign gynecology. Obstet Gynecol. 2014;124(3):585–588. - PubMed
    1. Georgiou AN, Rassweiler J, Herrmann TR, et al. . Evolution and simplified terminology of natural orifice transluminal endoscopic surgery (NOTES), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). World J Urol. 2012;30(5):573–580. - PubMed
    1. Burnett AF, Rojo MO. Vaginal natural orifice transluminal endoscopic surgery for gynecologic and gynecologic oncology procedures. In: Marchand G., editor. Single Port Gynecologic Laparoscopic and Robotic-Assisted Surgery. London: Intech Open; 2021. Accessed: May 26, 2022. Available from: https://www.intechopen.com/chapters/76497.

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