Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution: The Next Frontier in Gynecologic Minimally Invasive Surgery.

In addition, the vNOTES group had lower pain scores and shorter operative times but a nonsignificant trend toward higher complications, mostly due to bleeding. 49 A systematic review and meta-analysis comparing vNOTES to laparoscopic hysterectomy published in 2020 included one RCT and five retrospective cohort trials. 50 Authors found that vNOTES had shorter operative times, shorter length of stay, and lower estimated blood loss with no difference in complications, readmissions, and pain scores.

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