Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES): Feasibility of an innovative approach

ObjectiveTo evaluate the feasibility and safety of performing a hysterectomy using the transvaginal natural orifice transluminal endoscopic surgery (NOTES).Materials and MethodsFrom May through December 2010, 16 patients with benign uterine diseases who were eligible for laparoscopic hysterectomy were recruited to undergo transvaginal NOTES at a tertiary referral medical center. Intraoperative and postoperative surgical outcomes were measured.ResultsAll of the included hysterectomies were completed via transvaginal NOTES without conversion to conventional laparoscopy. The mean (± standard error of mean (SEM)) uterine weight was 538.8 ± 102.9 g, the mean operative time was 122.7 ± 17.6 minutes, and the mean blood loss was 379.4 ± 95.4 mL. The mean postoperative hospital stay was 2.8 ± 0.2 days. No intraoperative or postoperative complications were noted in this series.ConclusionHysterectomy for the treatment of benign diseases can be feasibly carried out via transvaginal NOTES. However, prospective studies are needed to determine its full clinical applications.