Hysterectomy and ovarian cystectomy using natural orifice transluminal endoscopic surgery: An initial experience at Tzu Chi General Hospital

Abstract

Objectives:The objective of this study is to report our initial experience with patients undergoing transvaginal natural orifice transluminal endoscopic surgery (NOTES).Materials and Methods:From September 2016 to December 2016, patients who were not virgins and did not have pelvic inflammation or obliteration of the cul-de-sac who underwent NOTES hysterectomy or ovarian cystectomy (OC) were included in the study.Results:Transvaginal NOTES was performed smoothly in six patients, two patients (mean age 35 years, mean body mass index [BMI] 25) received an OC and four patients (mean age 49 years, mean BMI 27) underwent a hysterectomy. One patient with a hysterectomy received concurrent adhesiolysis. The mean surgical times were 74 and 75 min and blood loss was 50 and 87.5 ml in the OC and hysterectomy groups, respectively. One patient with a hysterectomy had a postoperative fever with 38°C last for 2 days. Pain scores were 0 at 48 h postoperatively in both groups.Conclusion:Transvaginal NOTES is a feasible and safe technique for hysterectomy and OC in our patients and those in previous reports. This procedure was minimally invasive with no scars on the abdomen as well as little pain.

Hysterectomy and bilateral adnexectomy using transvaginal natural orifice transluminal endoscopic surgery: The role of multichannel abdominal PORT and vaginal support ring

“…Further feasibility and safety features of NOTES hysterectomy was demonstrated by Lee et al, 13 in 137 cases by using special channel for performing transvaginal NOTES followed by use of double‐channel endoscope for transvaginal endoscopic surgery tubal ectopic pregnancy 18 . In some cases reports, gloves were used to device the port with porous channels 19 . Thus, the crucial limitation is the availability of efficient instrumentation/facility to successfully accomplish the procedure along with avoiding the risk of leakage of carbon dioxide pneumoperitoneum 16, 20 …”

Applying the Vaginal Approach for Benign Ovarian Cystectomy: Current Evidence and Future Applications

“…Two papers were included after snowball strategy of other relevant studies [10,11]. Of the 14 full text publications examined, ten met the inclusion criteria [5,[9][10][11][12][13][14][15][16][17]. Of the four studies that were excluded, three were unavailable in English and one was a duplicate study.…”

“…Ovarian cystectomy through the vaginal route was associated with reduced postoperative pain and higher satisfaction levels when compared with LOC in two retrospective case-control studies [5,13,15]. Similarly, time to return to work was demonstrated to be significantly reduced in VOC when compared with LOC [5].…”

“…Two graspers and a scope are used through the three trocars and after pneumoperitoneum is created, the cyst is either enuclated Future Sci. OA (2020) 6( 5) future science group and retrieved using an endopouch [15,17] or aspirated endoscopically following which it is exteriorized. Enuclation is performed similar to simple VOC [13].…”

Transvaginal natural orifice transluminal endoscopic surgery hysterectomy in a woman with uterine adenomyosis and multiple severe abdominal adhesions

“…[ 4 ] Thereafter, a variety of transvaginal NOTES have been reported in benign gynecology and gynecologic oncology, including adnexal surgery, hysterectomy, and myomectomy. [ 5 6 ]…”