Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES): feasibility of an innovative approach

Taiwan J Obstet Gynecol. 2012 Jun;51(2):217-21. doi: 10.1016/j.tjog.2012.04.009.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenomyosis / surgery
  • Blood Loss, Surgical
  • Feasibility Studies
  • Female
  • Humans
  • Hysterectomy, Vaginal / adverse effects
  • Hysterectomy, Vaginal / methods*
  • Leiomyoma / surgery*
  • Length of Stay
  • Middle Aged
  • Natural Orifice Endoscopic Surgery*
  • Operative Time
  • Organ Size
  • Uterine Cervical Dysplasia / surgery*
  • Uterine Cervical Neoplasms / surgery
  • Uterine Neoplasms / surgery*
  • Uterus / pathology*