Standardised step by step approach to adnexectomy by Vaginal Natural Orifice Transluminal Endoscopic Surgery

Baekelandt, Jan; Noori, Nargis; Hofmann, Lauren; Mansoor, A.; Kapurubandara, Supuni

doi:10.1016/j.ejogrb.2022.05.021

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…Vaginal natural orifice transluminal endoscopic surgery has advantages, such as reduced postoperative pain, shorter exhaust time and hospital stay, and absence of postoperative scar, which aligns with the concept of the day-care surgery ( 12 , 29 ). In this retrospective preliminary study, we compared the perioperative data of vNOTES for ovarian cystectomy in the day-care procedure with those of single-port laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 66%

“…With the development of medical devices and the popularization of minimally invasive concepts, patients prefer surgeries that offer better esthetic outcomes, including those that inflict no or smaller scar ( 8 , 9 ), such as needleoscopic and percutaneous-assisted surgery ( 10 , 11 ). Currently, the minimally invasive approaches for ovarian cystectomy are vaginal natural orifice transluminal endoscopic surgery (vNOTES) and transumbilical laparoendoscopic single-site surgery (TU-LESS) ( 12 , 13 ). Meanwhile, enhanced recovery after surgery (ERAS) has developed rapidly, which optimizes the clinical path of perioperative treatment, reduces the stress response of surgical trauma, shortens hospital stay, and promotes rapid recovery of patients ( 14 – 16 ).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Xie

Huang

et al. 2023

Front. Med.

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IntroductionAlthough previous studies have shown that vaginal natural orifice transluminal endoscopic surgery (vNOTES) has the advantages of causing less pain, faster recovery, and better concealment of surgical incisions, which aligns with the concept of the day-care procedure, this approach poses a greater risk of damaging adjacent organs (i. e., rectum and bladder) due to its anatomical specificity. Moreover, the day-care procedure may lead to relatively less preoperative evaluation and postoperative care. Hence, it is necessary to explore the safety and effectiveness of vNOTES for ovarian cystectomy in the day-care procedure, to provide a theoretical basis for the wider development of vNOTES surgery.Materials and methodsThis retrospective study included 131 patients at our hospital who underwent ovarian cystectomy from September 2021 to October 2022. Based on the surgical approach, patients were classified into transumbilical laparoendoscopic single-site surgery (LESS) and vNOTES groups. The patients' demographic characteristics and follow-up data were collected during the perioperative period and 1-month postoperatively.ResultsVaginal natural orifice transluminal endoscopic surgery has less postoperative exhaust time, a lower postoperative 6-hour pain score, and a lower incidence of analgesic drug use, with higher surgical conversion incidence. Multiple linear regression analysis showed that the surgical conversion, chocolate cyst, bilateral cyst, and pelvic adhesion increased the operation duration by ~43 (95% CI: 10.309, 68.152, p < 0.001), 15 (95% CI: 6.342, 45.961, p = 0.036), 10 (95% CI: 3.07, 40.166, p = 0.019), and 8 (95% CI: 4.555, 26.779, p = 0.035) min, respectively. Interestingly, vNOTES decreased the operation duration by ~8.5 min (95% CI: −18.313, −2.699, p = 0.033).ConclusionVaginal natural orifice transluminal endoscopic surgery was equally safe and effective for ovarian cystectomy compared to LESS. vNOTES aligned with the concept of the day-care procedure due to its reduced postoperative pain, shorter exhaust time, and absence of scarring. However, surgeons should conduct a comprehensive preoperative evaluation and exclude patients suspected to have severe pelvic adhesions.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Xie

Huang

et al. 2023

Front. Med.

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“…Meanwhile, whether vNOTES can be performed repeatedly has become a huge concern among gynecologists and endoscopists. 6,7,15,16 Some experts are of the opinion that the reentry via the culdotomy of previous vNOTES should be avoided, 16 while the clinical evidence supporting such an opinion is still lacking. Traditional laparoendoscopy can easily enter the abdominal cavity through the previous entrance and use new trocar sites on the abdominal walls.…”

Section: Discussionmentioning

confidence: 99%

“…With the unprecedented development of minimally invasive surgical techniques and equipment, the vNOTES approach has gained increasing popularity in general surgery, urology and gynecology. Meanwhile, whether vNOTES can be performed repeatedly has become a huge concern among gynecologists and endoscopists 6,7,15,16 . Some experts are of the opinion that the re‐entry via the culdotomy of previous vNOTES should be avoided, 16 while the clinical evidence supporting such an opinion is still lacking.…”

Section: Discussionmentioning

confidence: 99%

Repeated transvaginal natural orifice transluminal endoscopic surgery: An initial Chinese experience

Feng

Liu

et al. 2023

J of Obstet and Gynaecol

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AimsTo investigate the perioperative outcomes and sexual function of patients undergoing repeated transvaginal natural orifice transluminal endoscopic surgery (vNOTES).MethodsWe retrieved the records of patients who underwent vNOTES twice at our institute between April 2019 and December 2022 and analyzed their baseline information and perioperative complications, and compared the pre‐ and postoperative sexual function of both vNOTES.ResultsPatients' mean age and body mass index were 29.00 ± 3.59 and 30.4 ± 4.00 years and 21.89 ± 3.69 and 22.76 ± 3.88 kg/m2, respectively, when receiving the first and second vNOTES. Ectopic pregnancy was the most frequent indication for vNOTES, with 7 cases in the first vNOTES and 11 cases in repeated vNOTES. The interval between the two vNOTESs ranged from 9 days to 38 months. The operation duration (63.33 ± 13.71 vs. 67.33 ± 22.51 min, p = 0.723), intraoperative estimated blood loss (32.00 ± 20.42 vs. 30.00 ± 9.26 mL, p = 0.429), and duration of postoperative hospital stay (2.20 ± 0.56 vs. 2.40 ± 0.51 days, p = 0.082) of both vNOTESs were comparable. No significant differences were found in any of the domains in the comparison of pre‐first and post‐first vNOTES, pre‐second and post‐second vNOTES, and pre‐first and post‐second vNOTES female sexual function index. None of the patients delivered after the second vNOTES.ConclusionRepeated vNOTES is safe and feasible. No significant change in the patients' sexual function was found in our cohort after the first and second vNOTES.

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Too big to bag? - Technique for bagging very large adnexal masses via vNOTES

Baekelandt,

Van Camp,

Vercammen

et al. 2024

Journal of Gynecology Obstetrics and Human Reproduction

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Standardised step by step approach to adnexectomy by Vaginal Natural Orifice Transluminal Endoscopic Surgery

Cited by 5 publications

References 16 publications

Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Repeated transvaginal natural orifice transluminal endoscopic surgery: An initial Chinese experience

Too big to bag? - Technique for bagging very large adnexal masses via vNOTES

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