This study compares vaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH) in terms of clinical outcomes, complications, and recovery.
A retrospective study was conducted on 143 patients who underwent hysterectomy for benign gynecologic conditions (vNOTES: 63; TLH: 80). Demographic, intraoperative, and postoperative outcomes were analyzed.
vNOTES had a significantly shorter operative time (87 ± 22 vs. 103 ± 22 min,  < .001) and lower blood loss (138 ± 99 vs. 302 ± 132 cm,  < .001). Postoperative pain scores were lower on days 1, 3, and 7 ( < .001). Patients ambulated earlier (5.87 ± 1.11 vs. 6.59 ± 1.28 h,  < .001) and resumed daily activities faster (6.83 ± 1.1 vs. 7.89 ± 1.17 days,  < .001). No significant differences were found in hospital stay ( = .10), intraoperative complications ( = 1.000), or re-intervention/readmission rates ( = 1.000).
vNOTES is a safe, effective alternative to TLH with advantages in efficiency, pain management, and recovery. However, its learning curve may limit widespread use. Further studies are needed to confirm long-term benefits.