Scarless Surgery in Gynecology: V-NOTES

Gynecological Surgeries

Today's surgical procedures are now shifting towards minimally invasive surgeries, that is, methods that cause the least damage to body tissues. Advances in technology also bring about many innovations in the health sector.

The first choice in gynecological surgeries that are accepted in the world is always the surgeries that can be performed vaginally. Laparoscopic surgery, known as the closed method, or the open method, which is the least preferred method, is used to perform surgical interventions that cannot be performed vaginally. However, the number of surgical interventions that can be performed vaginally is very limited and these interventions can be performed especially in case of uterine prolapse. The V-NOTES technique is a method that allows many surgical interventions to be performed vaginally.

What is the V-NOTES Method?

The V-NOTES (Vaginal Natural Orifice Transluminal Endoscopic Surgery) method is the method of performing the surgery through the vaginal route with a special apparatus, endoscopically with a closed method.

What are the Advantages of the V-NOTES Method?

• The V-NOTES technique provides easier access to the ovaries and tubes, unlike traditional vaginal surgery. Since this method is performed with the aid of a camera, even small details such as bleeding can be detected more easily and treated more effectively. This is more advantageous than the vaginal surgical methods that have been used for many years.
• It is safe and comfortable for obese (overweight) patients.
• It is possible for patients to be discharged from the hospital in a very short time after surgery.
• Generally, the patient can be discharged even on the same day.
• Since the hospital stay is very short, the probability of patients getting nosocomial infections is greatly reduced.
• Since the amount of pain is very low after the operation, operations that do not require the use of painkillers can be performed.
• Since there is no surgical incision in the patient's abdomen, it does not cause any cosmetic problems, and therefore the results in patients are satisfactory.
• In people who have had a lot of abdominal surgery before, intestinal injuries may occur at the beginning of the abdominal surgery in abdominal surgery. Since there is no abdominal access in operations performed with this method, this risk does not exist.
• In addition, the V-NOTES method is considered a safer choice in patients who have had previous surgery for hernia, especially in patients who have used a patch.
• At the end of this surgical method, the patient has the opportunity to return to social life in a very short time.

What are the Disadvantages of the V-NOTES Method?

• Since the V-NOTES method is a very new method, the number of experts who practice is low.
• Since the V-NOTES method is still a very new method, the number of centers that practice is very low.

Which Surgeries Can Be Performed With V- NOTES Method?

Many gynecological surgeries can be performed with the V-NOTES method. Here are some examples:

• Hysterectomy (womb removal) surgeries
• Ovarian cysts (eg: Dermoid cyst) surgeries
• Tubal ligation surgeries
• Surgeries related to ectopic pregnancy
• Sagging operations (such as uterine prolapse, vaginal cuff prolapse)
• Whether the tubes are open or not can be evaluated in infertile patients.
• Myomectomy (Depending on the location of the fibroid, surgery to remove some fibroids)
• Diagnostic

To Whom This Method Cannot Be Applied?

In some cases, the application of the V-NOTES method is not recommended:

• In pregnant women,
• Virgine women,
• In women with deep endometriosis (chocolate cyst),
• In women with tuboovarian abscess

Apart from this, this operation can be performed on all women.

Conclusion:

V- NOTES surgery is becoming a more preferred method of surgery with each passing day. Rapid discharge, rapid return to social life, no or very little pain, being applicable in obese patients, and not leaving any cosmetic scars are among the most preferred reasons.

The disadvantages of the V-NOTES technique are that the history of the technique is very new and the number of centers performed is scarce. In the near future, with the widespread use of the technique, it will be much more preferable.

Stay well…