Objective: To compare surgical outcomes between transvaginal natural orifice transluminal endoscopic surgery for hysterectomy (vNOTESH) and total laparoscopic hysterectomy (TLH) for the benign uterine diseases.

Materials and Methods: A retrospective review of electronic medical records of women that underwent vNOTESH between January 2019 and June 2020 (n=33) and TLH between June 2017 and August 2019 (n=33) in Bangkok Hospital Udon, Udonthani Province, Thailand was carried out. Measurement outcomes included operative time, estimated blood loss, intra- and post- operative complications, and post-operative pain assessment.

Results: One woman of the TLH group was excluded from the study because of severe adhesion. The mean age and BMI were not significantly different between the groups. There was no intra-operative complication in both groups. A median operative time was significantly shorter in the vNOTESH at 73 minutes (30 to 260 minutes than in the TLH at 140 minutes (75 to 296minutes), p<0.0001]. Post-operative pain scores were significantly less in the vNOTESH than in the TLH. In addition, the number of women who needed the added analgesics were significantly less in the vNOTESH than the TLH groups at 6.1% versus 46.9% (p=0.001), respectively. However, the amount of blood loss and post-operative complication were not significantly different between the two groups.

Conclusion: The present retrospective study demonstrated that the vNOTES is a feasible and safe procedure for hysterectomy in experienced hands and well-selected cases. This new technique is superior not only in taking less operative time and in achieving less postoperative pain, but also from the cosmetic aspect. Hence, it may be an alternative method for hysterectomy of the benign uterine diseases in the future.

Keywords: Hysterectomy; Natural orifice transluminal endoscopic surgery (NOTES); Surgical outcomes; Total laparoscopic hysterectomy

DOI: doi.org/10.35755/jmedassocthai.2021.08.12643

Received 1 March 2021 | Revised 12 July 2021 | Accepted 12 July 2021