A Single Center Retrospective Study of VNOTES Hysterectomy, Laparoscopic Hysterectomy and Vaginal Hysterectomy Operations

Abstract

In our study, we aimed to retrospectively compare vNOTES hysterectomy, a new method, with a vaginal hysterectomy (VH) and total laparoscopic hysterectomy (TLH). Our study included 186 hysterectomy cases (62 vNOTES hysterectomy, 62 VH, and 62 TLH) with benign indications diagnosed between 2021 and 2022. Our study is a retrospective and single-center study. Three surgical techniques were evaluated comparatively according to demographic characteristics and surgical results. The least hemoglobin (Hb) decline and the longest mean operation time were observed in the vNOTES hysterectomy group. When discharge times were compared, it was observed that the vNOTES hysterectomy group was discharged significantly shorter than the TLH group (P: .022 < .05). The lowest 6th-hour pain score of 1.53 was observed in the vNOTES hysterectomy group. History of pelvic surgery and cesarean section were higher in the vNOTES hysterectomy group than in the VH group. Also, oophorectomy and salpingectomy rates were higher in the vNOTES hysterectomy group than in the VH group. When intraoperative complications were evaluated, bladder perforation was encountered in one vNOTES hysterectomy and two VH operations, and bleeding was observed in one VH operation. The VH group was the least costly operation compared to vNOTES hysterectomy and TLH (P: .003 < .05, P: .01 < .05). Aesthetic results can be achieved for patients by using the vaginal route. With all these results, we believe that vNOTES hysterectomy is a safe alternative to TLH and VH.