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). Materials and 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. Conclusion: 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.