The following is a summary of “Feasibility and safety of vNOTES for gynecological procedures in obese patients,” published in the December 2023  issue of Obstetrics and Gynecology by Hurni, et al.

For a study, researchers sought to find out if transvaginal natural orifice transluminal endoscopic surgery  (vNOTES) could be done safely and effectively on obese women with both normal and malignant reproductive conditions. They looked at information from 79 obese patients (BMI > 30 Kg/m2) who had reproductive procedures done by vNOTES between May 2020 and April 2023. The most important result was whether or not the treatment could be done as planned. For groups of patients in obesity class I (BMI 30.1 to 34.9 Kg/m2), class II (BMI 35.0 to 39.9 Kg/m2), and class III (BMI ≥ 40.0 Kg/m2), data were shown.

In 39 cases (49.4%), patients were obese in class I, in 27 cases (34.2%), and 13 cases (16.4%), they were obese in class III. Fifty-two patients, or 65.8%, had a vNOTES hysterectomy, while 26 patients, or 32.9%, only had treatments on the adnexa, and one patient, or 1.3%, had a myomectomy. The conversion rate was 0% in obesity class I, 11.1% in obesity class II, and 7.7% in obesity class III. One case (1.3%) had a bladder injury during surgery, and two cases (2.5% of the total) had a rectal serosal tear. Three cases (3.8%) of wound infection, two cases (2.5%) of cystitis, and one case (1.3%) of deep vein thrombosis were seen after surgery.

The study showed that pelvic vNOTES treatments can be done safely and effectively on obese people. However, obesity might mean that treatments take longer and are more complicated, especially for people in obesity classes II and III.

Source: sciencedirect.com/science/article/abs/pii/S246878472300154X