Vaginally Assisted NOTES hysterectomy with adnexectomy (vNOTES) compared to conventional laparoscopy. A retrospective observational cohort study.

OBJECTIVE To compare vNOTES hysterectomy with salpingectomy/salpingo-oophorectomy to standard laparoscopic access. METHODS Medical records for patients undergoing hysterectomy with adnexectomy for benign disease indication between 1 February 2019 and 1 February 2020 were retrospectively examined. Exclusion criteria were endometriosis, previous pelvic radiotherapy, inflammatory pelvic disease history, any other concurrent surgery, laparotomy, robotic surgery, and/or traditional vaginal hysterectomy. RESULTS Among 86 patients, 21 (24.4%) were allocated to a vNOTES group and 65 (75.6%) were allocated to a conventional laparoscopy (LAP) group. Mean ages for the groups were 47.19 ± 11.11 y and 46.69 ± 9.11 y, respectively (p = 0.928). There were no statistically significant differences in age, body mass index, arterial hypertension/diabetes, smoking, menopausal status, obstetric history, number of abdominal surgeries, or pre-operative hemoglobin level between the two groups. The mean (range) operative times were 111.90 (80-180) min in the vNOTES group and 113.98 (64-350) min in the LAP group (p = 0.904). There were also no statistically significant differences in terms of surgery indication, specific and unspecific complications, conversions, blood transfusion, reoperation, significant ileus/emesis and hospital stay. CONCLUSIONS Based on the parameters assessed, we found NOTES to be comparable to laparoscopy among our cohort.