Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES): feasibility of an innovative approach.
OBJECTIVE
To evaluate the feasibility and safety of performing a hysterectomy using the transvaginal natural orifice transluminal endoscopic surgery (NOTES).


METHODS
From May through December 2010, 16 patients with benign uterine diseases who were eligible for laparoscopic hysterectomy were recruited to undergo transvaginal NOTES at a tertiary referral medical center. Intraoperative and postoperative surgical outcomes were measured.


RESULTS
All of the included hysterectomies were completed via transvaginal NOTES without conversion to conventional laparoscopy. The mean (± standard error of mean (SEM)) uterine weight was 538.8±102.9 g, the mean operative time was 122.7±17.6 minutes, and the mean blood loss was 379.4±95.4 mL. The mean postoperative hospital stay was 2.8±0.2 days. No intraoperative or postoperative complications were noted in this series.


CONCLUSIONS
Hysterectomy for the treatment of benign diseases can be feasibly carried out via transvaginal NOTES. However, prospective studies are needed to determine its full clinical applications.
Division of Gynecologic Endoscopy, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Chang Gung University School of Medicine, Taiwan.
Hsuan
H
Su
Chih-Feng
CF
Yen
Kai-Yun
KY
Wu
Chien-Min
CM
Han
Chyi-Long
CL
Lee
D062788:Adenomyosis / Q000601:surgery; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D061646:Operative Time; D009929:Organ Size; D002583:Uterine Cervical Neoplasms / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery*; D014599:Uterus / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000601:surgery*