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Hysterectomy Clinic

Vaginal NOTES (vNOTES) hysterectomy, also known as vaginal assisted NOTES hysterectomy (VANH), is a scar-free minimally invasive surgical procedure that utilizes the vagina as a surgical route to remove the uterus. The procedure involves using the natural body orifices to access an individual’s body for surgery, in this case the uterus.

Benefits of vNOTES Hysterectomy

Some of the benefits of vaginal assisted NOTES hysterectomy include:

  • Minimal blood loss
  • Shorter operative time
  • Minimal post-operative pain
  • If required additional vaginal support is easily accomplished
  • Scar-free procedure

Preparation for the vNOTES Procedure

Prior to the procedure, the doctor may advise the patient on any pre-surgical tests and also give instructions for eating, drinking, and taking medication. This includes going nil-by-mouth for at least 6 hours prior to the procedure. Additionally, the surgeon may ask the patient not to take blood thinning medication as this may lead to excessive bleeding during surgery.

The Procedure

During the procedure, which is performed under general anesthesia, the surgeon will make an incision in the vagina and insert a specialized vNOTES device. This will provide the surgeon with access to the patient’s uterus, and/or fallopian tubes and ovaries.

He/she will then inflate the patient’s abdomen with carbon dioxide gas to give the surgeon a clear visualization and the target area and its surroundings. In order to perform the procedure with utmost precision and visualization, the surgeon inserts a high-definition camera and specialized instruments through the vNOTES device. He/she then removes the womb, cervix, or any other part of the reproductive system that requires removal.

Upon completion of the procedure, the vNOTES is removed, the gas deflated, and all the internal incisions are sutured.

What to Expect After the vNOTES Hysterectomy Procedure

Immediately after the procedure, the patient may feel drowsy and tired for several hours as the effects of anesthesia wear off.

The patient may be discharged on the same day after the procedure. However, in some cases, the patient may need to stay for a day or longer depending on their specific case, and if any complications occurred.

After the patient leaves the hospital, it is recommended that she follows the surgeon’s home care instructions. In the first few days after the procedure, the patient may experience bleeding similar to a light period that comes and goes but decreases over time.

Other vNOTES procedures

  • Salpingectomy – removal of fallopian tubes
  • Oophorectomy – removal of ovary
  • Ovarian cystectomy – removal of ovarian cysts
  • Vaginal vault suspension – to correct pelvic organ prolapse
  • Myomectomy – removal of uterine fibroids (selected cases)
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