Comparison outcome between total laparoscopic hysterectomy and transvaginal NOTES hysterectomy in Sunpasittiprasong hospital

Abstract

Background: Hysterectomy is one of the most frequent gynaecological procedures performed for various uterine pathologies. There is transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has emerged as an alternative approach for conducting hysterectomies

Objective: To compare hysterectomy outcomes by total laparoscopic hysterectomy (TLH) versus transvaginal natural orifice transluminal endoscopic surgery (vNOTES).

Material and method: A retrospective study was done by collecting the data from medical records. All women who underwent TLH and vNOTES in Sunpasittiprasong hospital by one surgeon during 1 June 2018 to 30 May 2022 were included.

Results: Eighty-four participants were included in this study, who underwent conventional TLH (n=51) or vNOTES hysterectomies (n=33), were included in this study. The visual analogue scale (VAS) scores at 6 and 24 hours postoperative were significantly higher in the TLH (VAS score = 6, IQR 3-8 and VAS score = 4, IQR 2-6) compared to the vNOTES hysterectomy group (VAS score = 4, IQR 3-8 and VAS score = 3, IQR 2-6) (p<0.001 and p<0.001), but no statistically significant different in total operating time, serum hemoglobin change, uterine weight, estimated blood loss, postoperative stay, conversion of laparoscopy and complications.

Conclusions: These results indicate that vNOTES hysterectomy has the same efficacy and safety as TLH with the benefit of better postoperative pain score, so that it can be a promising approach for treating a variety of different uterine pathologies and, furthermore, that it can be an alternative to TLH.