Identifying the Right Candidates for vNOTES
Transvaginal access for hysterectomy offers an adhesion-free route, avoiding abdominal incisions and potentially improving outcomes compared to traditional abdominal approaches, especially when prior surgeries distort anatomy.
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This chapter discusses selecting appropriate candidates for vaginal natural orifice transluminal endoscopic surgery (vNOTES), contrasting it with abdominal entry routes that surgeons are more accustomed to. It outlines how prior abdominal surgeries, abdominal wall defects, and implanted foreign bodies can distort anatomy and increase intra-abdominal injury risk, and notes that a transvaginal approach may use a potentially adhesion-free access area, potentially improving cosmetic outcomes and reducing pain. The chapter also includes cited literature on vNOTES hysterectomy feasibility and outcomes, and on pelvic imaging and diagnostic tools for endometriosis. It does not explicitly present original data for vNOTES candidate selection, instead functioning as an atlas chapter with literature context. Relevance to endometriosis: the chapter cites multiple endometriosis diagnostic and imaging studies (e.g., sliding sign and MRI/sonography consensus) in addition to vNOTES surgical material, though its main focus is vNOTES candidate identification.
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References (16)
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