Surgical Outcomes of Hysterectomy by Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Compared with Total Laparoscopic Hysterectomy (TLH) in Women with Benign Gynecologic Indications
Keywords:
hysterectomy, vNOTES, total laparoscopic hysterectomyAbstract
Background: Hysterectomy is one of the most common gynecologic procedures. Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) is a novel, scarless approach that offers an alternative to conventional laparoscopic hysterectomy.
Objective: To compare surgical outcomes between hysterectomy performed by vNOTES and Total Laparoscopic Hysterectomy (TLH).
Materials and Methods: This retrospective study included 252 women who underwent hysterectomy for benign gynecologic diseases between October 2023 and March 2025. After exclusions, 56 patients were allocated to the vNOTES group and 161 to the TLH group. The primary outcome was successful completion of surgery without conversion. Secondary outcomes included operative time, blood loss, intraoperative and postoperative complications, postoperative pain, hospital stay, and readmission rate.
Results: No significant differences were observed between the two groups regarding conversion rate, operative time, complications, length of hospital stay, or readmission rate. However, postoperative pain was significantly lower in the vNOTES group compared with the TLH group. At 24 hours postoperatively, no patients in the vNOTES group reported a pain score >4, whereas 2.5% of patients in the TLH group did (p < 0.001). Conversely, intraoperative blood loss was significantly higher in the vNOTES group 150 (50-300) ml. compared with the TLH group 50 (20-100) ml., p < 0.001).
Conclusion: Hysterectomy by vNOTES is feasible in tertiary hospitals and demonstrates comparable outcomes to TLH, with the advantage of reduced postoperative pain. Nevertheless, given the retrospective design and potential selection bias, prospective studies are warranted to confirm these findings.
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นลิขสิทธิ์ของมหาราชนครศรีธรรมราชเวชสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากวารสารมหาราชนครศรีธรรมราชเวชสาร ก่อนเท่านั้น
