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A randomized trial comparing vNOTES hysterectomy with total laparoscopic hysterectomy found that vNOTES was non-inferior for successful completion without conversion and enabled a greater proportion of women to leave hospital within 12 hours. Hospital stay was also shorter. These findings support vNOTES as a credible minimally invasive route for selected benign hysterectomy patients. For surgeons, the technique requires familiarity with vaginal access, endoscopic orientation and complication management. Patient selection remains important, particularly in the presence of extensive pelvic adhesions, malignancy suspicion or anatomic factors that make the vaginal approach difficult. The evidence is most useful when discussing route-of-surgery choice as a shared decision involving operative feasibility, recovery, surgeon skill and patient preference.
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A randomized trial comparing vNOTES hysterectomy with total laparoscopic hysterectomy found that vNOTES was non-inferior for successful completion without conversion and enabled a greater proportion of women to leave hospital within 12 hours. Hospital stay was also shorter. These findings support vNOTES as a credible minimally invasive route for selected benign hysterectomy patients. For surgeons, the technique requires familiarity with vaginal access, endoscopic orientation and complication management. Patient selection remains important, particularly in the presence of extensive pelvic adhesions, malignancy suspicion or anatomic factors that make the vaginal approach difficult. The evidence is most useful when discussing route-of-surgery choice as a shared decision involving operative feasibility, recovery, surgeon skill and patient preference.
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