ArticleJSLS : Journal of the Society of Laparoendoscopic Surgeons
Safety and Feasibility of Vaginal Natural Orifice Surgery Hysterectomy for Enlarged Uteri.
Article in JSLS : Journal of the Society of Laparoendoscopic Surgeons. 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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6 authors.
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Abstract
Objective: This study evaluated the impact of uterine size on surgical outcomes in vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy and compared perioperative outcomes with conventional laparoscopic hysterectomy (LH) in patients with large uteri. Methods: This single-center, retrospective cohort study included 812 patients who underwent hysterectomy between January 2024 and January 2026. Patients were categorized into 3 groups: vNOTES with small uteri (n = 102), vNOTES with large uteri (n = 87), and LH with large uteri (n = 623). Primary outcomes were operative time, estimated blood loss, conversion rates, and complications. Secondary outcomes included postoperative complications, hospitalization period, postoperative hemoglobin change, uterine weight and pain scores assessed using the visual analogue scale (VAS) at 12 and 24 hours postoperatively. Results: There were no statistically significant differences among 3 groups regarding operative time, hemoglobin drop or estimated blood loss ( Conclusion: vNOTES hysterectomy is a safe and feasible approach for patients with enlarged uteri, demonstrating noninferiority to conventional laparoscopy. vNOTES may offer lower risk of conversion to laparotomy compared to laparoscopy in cases of uterine enlargement.
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