Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study
Background This study aimed to compare the operative outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH). We also aimed to determine the feasibility of performing vNOTES hysterectomy in primary hospitals.Methods This prospective...
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Taylor & Francis Group
2025-12-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/08941939.2025.2515054 |
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| author | Shuying Fang Yuandan Xia Jianbo Jin Jiaren Zhang Lei Lu |
| author_facet | Shuying Fang Yuandan Xia Jianbo Jin Jiaren Zhang Lei Lu |
| author_sort | Shuying Fang |
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| description | Background This study aimed to compare the operative outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH). We also aimed to determine the feasibility of performing vNOTES hysterectomy in primary hospitals.Methods This prospective cohort study enrolled 54 patients with indications for hysterectomy related to benign uterine disease without prolapse, between September 1, 2020, and November 30, 2024. The patients were categorized into two groups: vNOTES hysterectomy and TLH (n = 27 each). Surgical outcomes, including operative time, blood loss, recovery parameters, and complications, were assessed.Results Preoperative baseline characteristics were comparable between the two groups. The vNOTES group had a longer mean operative time (187.6 vs. 154.4 min, p < 0.05) and greater median blood loss (100 vs. 30 mL, p < 0.05) compared to the TLH group. However, there were no significant differences in conversion rates, uterine weights, complications, 24-h pain scores, hospital stay, costs, or readmission rates. The vNOTES group demonstrated shorter times to postoperative ambulation, earlier return of bowel function (anal exhaust), and reduced urinary catheter insertion duration (p < 0.05).Conclusion vNOTES hysterectomy is feasible in primary hospitals, with surgical outcomes comparable to those of TLH. Patients who underwent vNOTES experienced faster recovery, indicating that it serves as a potential minimally invasive alternative to TLH. However, the small sample size warrants further studies to validate these findings. |
| format | Article |
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| institution | Kabale University |
| issn | 0894-1939 1521-0553 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Journal of Investigative Surgery |
| spelling | doaj-art-5dee032d21794874a7b79c5f8c4689c12025-08-20T03:46:53ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532025-12-0138110.1080/08941939.2025.2515054Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort StudyShuying Fang0Yuandan Xia1Jianbo Jin2Jiaren Zhang3Lei Lu4Department of Gynecology, Hangzhou Fuyang Women and Children Hospital, Hangzhou, ChinaDepartment of Gynecology, Hangzhou Fuyang Women and Children Hospital, Hangzhou, ChinaDepartment of Gynecology, Hangzhou Fuyang Women and Children Hospital, Hangzhou, ChinaDepartment of Gynecology, Hangzhou Fuyang Women and Children Hospital, Hangzhou, ChinaDepartment of Gynecology, Hangzhou Fuyang Women and Children Hospital, Hangzhou, ChinaBackground This study aimed to compare the operative outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH). We also aimed to determine the feasibility of performing vNOTES hysterectomy in primary hospitals.Methods This prospective cohort study enrolled 54 patients with indications for hysterectomy related to benign uterine disease without prolapse, between September 1, 2020, and November 30, 2024. The patients were categorized into two groups: vNOTES hysterectomy and TLH (n = 27 each). Surgical outcomes, including operative time, blood loss, recovery parameters, and complications, were assessed.Results Preoperative baseline characteristics were comparable between the two groups. The vNOTES group had a longer mean operative time (187.6 vs. 154.4 min, p < 0.05) and greater median blood loss (100 vs. 30 mL, p < 0.05) compared to the TLH group. However, there were no significant differences in conversion rates, uterine weights, complications, 24-h pain scores, hospital stay, costs, or readmission rates. The vNOTES group demonstrated shorter times to postoperative ambulation, earlier return of bowel function (anal exhaust), and reduced urinary catheter insertion duration (p < 0.05).Conclusion vNOTES hysterectomy is feasible in primary hospitals, with surgical outcomes comparable to those of TLH. Patients who underwent vNOTES experienced faster recovery, indicating that it serves as a potential minimally invasive alternative to TLH. However, the small sample size warrants further studies to validate these findings.https://www.tandfonline.com/doi/10.1080/08941939.2025.2515054hysterectomynatural orifice transluminal endoscopic surgery (NOTES)laparoscopyvaginal surgeryminimally invasive surgery |
| spellingShingle | Shuying Fang Yuandan Xia Jianbo Jin Jiaren Zhang Lei Lu Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study Journal of Investigative Surgery hysterectomy natural orifice transluminal endoscopic surgery (NOTES) laparoscopy vaginal surgery minimally invasive surgery |
| title | Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study |
| title_full | Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study |
| title_fullStr | Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study |
| title_full_unstemmed | Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study |
| title_short | Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study |
| title_sort | comparison of surgical outcomes between vaginally assisted notes hysterectomy and laparoscopic hysterectomy in primary hospitals a prospective cohort study |
| topic | hysterectomy natural orifice transluminal endoscopic surgery (NOTES) laparoscopy vaginal surgery minimally invasive surgery |
| url | https://www.tandfonline.com/doi/10.1080/08941939.2025.2515054 |
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