vNOTES hysterectomy versus laparoscopic hysterectomy: experiences and outcomes in a tertiary center
Eralp Bulutlar, Gizem Berfin Uluutku Bulutlar, Latife Aslı Cilli, Çetin Kılıççı, Sadık Şahin
Abstract
Background This study compares vaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH) in terms of clinical outcomes, complications, and recovery.Methods A retrospective study was conducted on 143 patients who underwent hysterectomy for benign gynecologic conditions (vNOTES: 63; TLH: 80). Demographic, intraoperative, and postoperative outcomes were analyzed.Results vNOTES had a significantly shorter operative time (87 ± 22 vs. 103 ± 22 min, p < .001) and lower blood loss (138 ± 99 vs. 302 ± 132 cm3, p < .001). Postoperative pain scores were lower on days 1, 3, and 7 (p < .001). Patients ambulated earlier (5.87 ± 1.11 vs. 6.59 ± 1.28 h, p < .001) and resumed daily activities faster (6.83 ± 1.1 vs. 7.89 ± 1.17 days, p < .001). No significant differences were found in hospital stay (p = .10), intraoperative complications (p = 1.000), or re-intervention/readmission rates (p = 1.000).Conclusions vNOTES is a safe, effective alternative to TLH with advantages in efficiency, pain management, and recovery. However, its learning curve may limit widespread use. Further studies are needed to confirm long-term benefits.