Transvaginal Natural Orifice Transluminal Endoscopic Ovarian Cystectomy versus Laparoscopic Ovarian Cystectomy. A prospective quasi-randomized pilot study.
Ahmed Hesham Abdel Hakim, Gasser Mohamed El Bishry, Omar Gamal Farag Mustafa et al.
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In 30 seconds
This prospective quasi-randomized pilot study compared transvaginal natural orifice transluminal endoscopic surgery (vNOTES) with conventional laparoscopy for benign ovarian cystectomy in 20 premenopausal women at a tertiary centre. Ten women underwent each approach. vNOTES was completed in 80% of cases, compared with a 90% laparoscopic completion rate. Early pain scores were lower with vNOTES at 6 hours (VAS 6.0 vs 6.7) and 24 hours (VAS 3.0 vs 3.7), and patient satisfaction was significantly higher. Operative time was numerically shorter with vNOTES, but the difference was not statistically significant.
Key findings
- vNOTES was successfully completed in 80% of cases; laparoscopic completion was 90%.
- Pain scores favoured vNOTES at 6 hours (VAS 6.0 vs 6.7) and 24 hours (VAS 3.0 vs 3.7).
- Patient satisfaction was significantly higher with vNOTES.
- Mean operative time was 85.6 ± 38.4 min with vNOTES and 103.7 ± 31.6 min with laparoscopy (p = 0.26).
Why it matters
The findings suggest that a transvaginal endoscopic approach may reduce early postoperative pain and improve satisfaction for some patients undergoing benign ovarian cystectomy. However, the lower completion rate and pilot-scale evidence mean these results are preliminary. Comparative data from larger studies are needed to clarify feasibility, outcomes, and the role of vNOTES alongside conventional laparoscopy.
What to keep in mind
This was a small, 20-patient pilot study at a single tertiary centre, and vNOTES was not completed in all cases.