IMR Press / CEOG / Volume 50 / Issue 10 / DOI: 10.31083/j.ceog5010223
Open Access Review
The Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Procedures in Contemporary Gynecology: An Appraisal of the Published Evidence and a Review
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1 Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
2 Department of Obstetrics and Gynecology, Lebanese American University Medical Center-Rizk Hospital, 4505 Beirut, Lebanon
3 Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
4 Clinic for General and Pediatric Surgery, General Hospital Čačak, 32000 Čačak, Serbia
5 Department of Gynecology and Obstetrics, Pia Fondazione “Card. G. Panico”, 73039 Tricase (Lecce), Italy
6 Department of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), “Veris delli Ponti Hospital”, Scorrano, 73020 Scorrano (Lecce), Italy
*Correspondence: (Andrea Tinelli)
Clin. Exp. Obstet. Gynecol. 2023, 50(10), 223;
Submitted: 5 April 2023 | Revised: 28 June 2023 | Accepted: 14 July 2023 | Published: 23 October 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Objective: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is a kind of natural orifice transluminal endoscopic surgery in which the abdominal cavity is reached by using the natural orifices, such as the stomach, rectum, esophagus, and bladder. In comparison to traditional laparoscopic and robotic surgery, there are potential advantages of the vNOTES. This narrative review shows the use of vNOTES in contemporary gynecologic endoscopic surgery. Mechanism: MEDLINE, Scopus, and PubMed searches on these themes were conducted from 1990 to 2023 using a mix of keywords. Papers and articles were identified and included in this narrative review after the authors’ revision and evaluation. Findings in Brief: The vNOTES procedures allow a short surgery time, as well as estimated blood loss and postoperative pain. These procedures are safe and feasible in contemporary endoscopic gynecology surgery. Conclusions: The vNOTES procedures are beneficial for the patients, and to be added to other minimally invasive procedures, such as conventional laparoscopy and robotic surgery. However, further studies about the long-term outcomes of vNOTES procedures are still needed.

endoscopic surgery
minimally invasive surgery
Fig. 1.
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