Evidence map›Paper›PMID 41464775›Full record

ReviewJournal of clinical medicine2025

Indications and Limitations of vNOTES for the Surgical Staging of Early-Stage Ovarian Cancer: A Narrative Literature Review.

Vasilios Lygizos, Dimitrios Efthymios Vlachos, Dimitrios Haidopoulos, Aikaterini Karagouni, Antonia Varthaliti, Maria Fanaki, Nikolaos Thomakos, Christos Damaskos, Nikolaos Garmpis, Gerasimos Tsourouflis and 3 more

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Vasilios Lygizos1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0009-0001-2323-2563
Dimitrios Efthymios Vlachos1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0003-3740-2575
Dimitrios Haidopoulos1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Aikaterini Karagouni1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0001-8043-7760
Antonia Varthaliti1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0009-0008-8725-7103
Maria Fanaki1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0009-0003-6488-3842
Nikolaos Thomakos1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Christos DamaskosHellenic Minimally Invasive and Robotic Surgery (M.I.R.S.) Study Group, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0002-5454-2564
Nikolaos GarmpisHellenic Minimally Invasive and Robotic Surgery (M.I.R.S.) Study Group, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0001-9980-0056
Gerasimos TsourouflisHellenic Minimally Invasive and Robotic Surgery (M.I.R.S.) Study Group, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Stylianos KykalosHellenic Minimally Invasive and Robotic Surgery (M.I.R.S.) Study Group, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0002-8687-685X
Stavros Athanasiou1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Dimitrios DimitroulisHellenic Minimally Invasive and Robotic Surgery (M.I.R.S.) Study Group, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNatural Orifice Transluminal Endoscopic Surgery (NOTES) via the vagina (vNOTES) has recently appeared on the gynecology horizon as a fresh minimally invasive approach. Although vNOTES for benign adnexal conditions is being increasingly employed, very limited experiences exist for its application in ovarian tumors. In this review, the current state of vNOTES applicability for borderline ovarian tumors (BOTs) and estimated early-stage epithelial ovarian cancer (EOC) is assessed.

methodsA narrative literature review was performed to examine operative viability, perioperative safety and functional outcomes, and oncologic details as documented for patients with ovarian tumors undergoing vNOTES.

resultsIn the current literature, vNOTES has been utilized for adnexectomy, hysterectomy, infracolic omentectomy, peritoneal biopsies, and sampling of selective pelvic lymph nodes in carefully selected patients. The perioperative parameters-bleeding, perioperative pain, and length-of-stay indicators-have been satisfactory with minimal complications. For BOT, vNOTES can meet the requirements for all surgical goals except lymphadenectomy for metastasis evaluation for systemic management. In this context, lymphadenectomy is not necessary for BOT and therefore is no contraindication for vNOTES. However, for invasive EOC, this is a significant drawback as there is no lymphadenectomy for the evaluation and management for this complex subgroup. The oncology follow-up is prematurely limited and is heterogeneous and underpowered.

conclusionsBased on current available data, vNOTES is possible in a selected group of patients with borderline ovarian tumors and in patients with adnexal lesions that are believed to be in early-stage disease based upon imaging studies. For the treatment of invasive epithelial ovarian cancer, vNOTES should not be considered an independent staging procedure at any FIGO stage, but it might find a supplemental place in the setting of a hybrid procedure in a highly selected group of patients in an experienced center.

Indexed as

early-stage malignancyfeasibilityhysterectomyminimally invasive surgeryomentectomyoncologic outcomesovarian cancervNOTES

Identifiers

PMID41464775
PMCPMC12734015

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.