TY - JOUR
T1 - The Introduction of the vNOTES Hysterectomy in The Netherlands
T2 - A Nationwide Cohort Study
AU - Sluijter, Hilde M. M.
AU - Bekkers, Ilse P. W.
AU - Henschen, Rebecca
AU - van Alphen, Marcel
AU - Ebisch, Inge
AU - Kok, Helen S.
AU - Labrie, Julien
AU - van Leijsen, Sanne A. L.
AU - Oei, Angele L. M.
AU - Peters, Louisette W.
AU - Pijlman, Brenda M.
AU - Sikkema, J. Marko
AU - van Der Vlist, Matthieu Y.
AU - Voogdt, Kevin G. J. A.
AU - Vos, Nikki
AU - Woolderink, Jorien M.
AU - Smeets, Nicol A. C.
AU - Damoiseaux, Anne
AU - Huppelschoten, Aleida G.
AU - Wassen, Martine L. H.
AU - van Vliet, Huib A. A. M.
PY - 2025/11
Y1 - 2025/11
N2 - ObjectiveThis study aims to assess the peri- and postoperative outcomes of the vNOTES hysterectomy in the Netherlands during implementation.Study DesignNationwide cohort study.SettingvNOTES hysterectomies performed in the Netherlands by 15 hospitals since the implementation of the technique, from August 2019 to September 2024.Population673 patients undergoing vNOTES hysterectomy.MethodsDescriptive data are presented as frequencies with percentage or mean with range. Logistic regression was used to assess the risk of conversions/complications per BMI group.Main Outcome MeasuresPeri- and postoperative outcomes such as operating time, conversions, and complications.ResultsThe mean operating time was 67.4 min (range 24-210). There were 37 (5.5%) conversions and 94 (15.5%) complications. Nineteen (2.8%) complications were perioperative, and 75 (12.7%) postoperative. Ten (1.5%) of the perioperative complications were classified as Clavien-Dindo (CD) 1, and nine (1.3%) as CD3. Postoperatively, 18 patients (3.1%) had a reintervention (N = 17 CD3, N = 1 CD4), and two (0.3%) patients were admitted to the intensive care unit (CD4). The mean blood loss was 127 mL (range 50-2000), and 220 (37%) of patients were discharged the same day.ConclusionsThis large nationwide cohort study during implementation of the vNOTES hysterectomy demonstrates the safety and feasibility of this upcoming technique, reporting on a short surgery duration and a similar complication percentage compared to other methods of hysterectomy.
AB - ObjectiveThis study aims to assess the peri- and postoperative outcomes of the vNOTES hysterectomy in the Netherlands during implementation.Study DesignNationwide cohort study.SettingvNOTES hysterectomies performed in the Netherlands by 15 hospitals since the implementation of the technique, from August 2019 to September 2024.Population673 patients undergoing vNOTES hysterectomy.MethodsDescriptive data are presented as frequencies with percentage or mean with range. Logistic regression was used to assess the risk of conversions/complications per BMI group.Main Outcome MeasuresPeri- and postoperative outcomes such as operating time, conversions, and complications.ResultsThe mean operating time was 67.4 min (range 24-210). There were 37 (5.5%) conversions and 94 (15.5%) complications. Nineteen (2.8%) complications were perioperative, and 75 (12.7%) postoperative. Ten (1.5%) of the perioperative complications were classified as Clavien-Dindo (CD) 1, and nine (1.3%) as CD3. Postoperatively, 18 patients (3.1%) had a reintervention (N = 17 CD3, N = 1 CD4), and two (0.3%) patients were admitted to the intensive care unit (CD4). The mean blood loss was 127 mL (range 50-2000), and 220 (37%) of patients were discharged the same day.ConclusionsThis large nationwide cohort study during implementation of the vNOTES hysterectomy demonstrates the safety and feasibility of this upcoming technique, reporting on a short surgery duration and a similar complication percentage compared to other methods of hysterectomy.
KW - complications
KW - vaginal-assisted NOTES hysterectomy
KW - vNOTES hysterectomy
KW - ENDOSCOPIC SURGERY VNOTES
U2 - 10.1111/1471-0528.18307
DO - 10.1111/1471-0528.18307
M3 - Article
SN - 1470-0328
VL - 132
SP - 1810
EP - 1816
JO - Bjog-an International Journal of Obstetrics and Gynaecology
JF - Bjog-an International Journal of Obstetrics and Gynaecology
IS - 12
ER -