Comparison of vNOTES technique with conventional laparoscopy in gynecological emergency cases

Abstract

Background

Vaginal natural orifice transluminal endoscopic surgery (vNOTES) has emerged as a minimally invasive approach. This study aimed to evaluate the feasibility and surgical outcomes of the vNOTES method and compare it with conventional laparoscopy (CL) in gynecological emergency cases.

Material and methods

A retrospective study was conducted to compare vNOTES with CL regarding pre-/intra-/postoperative outcomes. The women who were operated on for emergency indications such as ectopic pregnancy, ovarian torsion, ovarian cyst rupture and acute abdominal pain were evaluated. Patients' age, gravidity, parity, medical/surgical history, height, weight, blood pressure, heart rate, pre-/postoperative hemoglobin and hematocrit levels, the quantity of aspirated hemoperitoneum, visual analog scale (VAS) pain scores six and 12 h postoperatively, duration of surgery and hospital stay were recorded.

Results

The study was conducted with 90 women. Sixty of them underwent CL, while 30 women had vNOTES. The vNOTES group had a significantly shorter duration of surgery −28.5 min (15–48 min) vs. 77 min (29–155 min), respectively, p < .001), shorter hospital stay − 32 h (11–125 h) vs. 38 h (12–201 h), respectively, p = .007), lower VAS scores after 6 h – 5 (4–7) vs. 6 (2–8), respectively, p < .001), and after 12 h − 2 (1–3) vs. 2 (1–5), respectively, p < .001) and a lower dose of postoperative analgesic administration − 2 (2–3) vs. 3 (1–5), respectively, p < .001) than the CL group.

Conclusion

vNOTES surgeries can be considered an alternative technique to CL by providing shorter surgery duration, lower postoperative pain scores, shorter hospital stays and better cosmetic outcomes.

Keywords:

• Laparoscopy
• natural orifice surgery
• gynaecological emergencies

Acknowledgment

The authors of the study acknowledge that no funding or financial grants were used.

Declaration of interest

The authors have no conflict of interest to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

There is no funding information to declare.