The vNOTES technique: scarless surgery
Minimally invasive surgery (MIS) is a technique that has completely revolutionized the field of surgical interventions. It allows for major procedures to be performed using a single incision, thus minimizing the number of scalpel incisions required in conventional surgeries. The vNOTES technique represents a significant advancement, as it involves accessing the inside of the abdomen through a natural orifice: the vagina.
In the Women's Unit we have two specialists in the field of minimally invasive surgery, who are Dr. Julio Álvarez Bernardi , Head of the Gynecologic Oncology Service of the UDM, and Dr. José Rubio Valtueña , specialized in gynecological endoscopy and minimally invasive oncologic surgery.
Thus, in today's article we will explain, with the help of Dr. Álvarez Bernardi, what the v-NOTES technique consists of and what its advantages and possible disadvantages are.
What is the vNOTES technique?
The vNOTES technique , as we mentioned, is an endoscopic surgery performed through the vagina . Although it is currently primarily indicated for benign uterine conditions such as fibroids or bleeding problems, it has already begun to be tested in oncology procedures.
Thus, thanks to this technique, it is possible to directly access the inside of the abdomen and obtain a much more complete view of the internal genital apparatus (body of the uterus, ovaries, fallopian tubes…).
How the technique is performed
The vNOTES technique consists of three phases :
- El approach through the vagina.
- Placement of a silicone device with two rings, one flexible for insertion into the body, and one rigid for insertion outside the vagina. This allows air to be introduced into the body and the vaginal entrance to be distended, allowing the telescope with the camera and two instruments to be inserted for surgery.
- Once the intervention is completed, the device is removed and the vagina is closed with a few stitches.
What advantages does the vNOTES technique offer?
One of the advantages is a shorter surgery time . Furthermore, there is a significant improvement in postoperative pain, and the risk of wound infection is considerably reduced, as there is no incision on the abdomen. For all these reasons, the hospital stay will be shorter , and recovery much faster.
What contraindications does the technique have?
As Dr. Álvarez explains, the main contraindication for vNOTES relates to cases where there are adhesions in the lower pelvis , which can hinder vaginal access and potentially cause injury to neighboring organs. This includes patients with endometriosis , a history of pelvic infections , or previous surgeries in the area.
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If you found this article interesting and would like to be seen by a specialist in Minimally Invasive Surgery, the Women's Unit at Ruber International Hospital has a specialized unit in this area. You can request more information by calling 91 387 51 72/73/74 or schedule an in-person consultation with top specialists.
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