ArticleTechniques in coloproctology2026
First worldwide comparison of right hemicolectomy for colon cancer using vaginal natural orifice transluminal endoscopic surgery (VNOTES) versus transvaginal natural orifice specimen extraction surgery (TVNOSE).
Article in Techniques in coloproctology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundIn colorectal transvaginal natural orifice specimen extraction (TVNOSE) surgery, the specimen is retrieved via the vagina instead of conventional transabdominal removal. Vaginal natural orifice transluminal endoscopic surgery (VNOTES) uses transvaginal access for bowel mobilisation, oncologic resection, anastomotic creation, followed by TVNOSE. We aimed to compare VNOTES versus TVNOSE for right hemicolectomy.
methodsFrom April 2023 to February 2025, our initial five consecutive VNOTES right hemicolectomy procedures were compared against five consecutive TVNOSE right hemicolectomies. Inclusion criteria for both procedures were elective non-metastatic right-sided colon adenocarcinoma resection with maximum tumour diameter < 6.0 cm. There were no differences in patient or tumour selection criteria between the TVNOSE and VNOTES procedures.
resultsAll patients underwent D3 lymphadenectomy with fully stapled antiperistaltic ileocolic anastomosis. No cases required conversion to open surgery or transabdominal specimen extraction. VNOTES had a longer median operative time by 105 min. The cumulative length of all abdominal wounds was significantly longer in the TVNOSE group compared to the VNOTES group at 27 mm vs. 10 mm, P = 0.012. There was a trend towards reduced postoperative day 1 and 2 pain scores, as well as quicker time to gastrointestinal recovery following VNOTES. Maximum tumour diameter, total lymph node harvest, and distribution of pathological T and N stages were comparable between both groups. There was one instance of postoperative ileus following TVNOSE surgery.
conclusionThis first worldwide comparison of VNOTES versus TVNOSE right hemicolectomy demonstrates comparable safety and short-term outcomes, with reduced abdominal wounds and potential benefits in early recovery following VNOTES.
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