Our Summary

In this study, researchers compared three methods of performing a hysterectomy: vNOTES hysterectomy, vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH). They looked at 186 cases of women who had these surgeries for non-cancerous reasons between 2021 and 2022.

The vNOTES method had the smallest drop in hemoglobin (a protein in red blood cells that carries oxygen), but took the longest time to perform. Patients who had the vNOTES procedure left the hospital quicker than those who had the TLH surgery. They also experienced the least amount of pain six hours after the operation.

Women who had previously had pelvic surgery or a cesarean section were more likely to have a vNOTES hysterectomy, and this method also had higher rates of ovary and fallopian tube removal. There were a few complications during surgery, including bladder damage and bleeding, but these were only seen in a few cases.

The vaginal hysterectomy was the cheapest out of the three methods. However, the vNOTES method was found to give pleasing aesthetic results as the surgery is performed through the vagina.

Overall, the researchers believe that the vNOTES method is a safe alternative to the other two methods.

FAQs

  1. What were the three methods of hysterectomy compared in the study?
  2. How does the vNOTES method of hysterectomy differ from the other two methods in terms of recovery and complications?
  3. Which method of hysterectomy is the most cost-effective according to the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic hysterectomy is to discuss with them the different surgical methods available, such as vNOTES, vaginal hysterectomy, and total laparoscopic hysterectomy, and their potential benefits and risks. It’s important for the patient to understand the differences in recovery time, pain levels, cost, and potential complications associated with each method, so they can make an informed decision about which approach is best for them. Additionally, the doctor may recommend considering factors such as previous pelvic surgery or cesarean section when determining the most suitable surgical approach. Ultimately, the goal is to ensure the patient has a successful surgery with minimal complications and a smooth recovery.

Suitable For

Patients who are typically recommended for a laparoscopic hysterectomy include those with non-cancerous gynecological conditions such as fibroids, endometriosis, abnormal uterine bleeding, or pelvic organ prolapse. Patients who have had previous pelvic surgery or a cesarean section may also be recommended for a laparoscopic hysterectomy, particularly the vNOTES method. It is important for patients to discuss with their healthcare provider to determine the best surgical approach for their individual case.

Timeline

Before the laparoscopic hysterectomy:

  • Patient consults with their gynecologist to discuss the need for a hysterectomy and the different surgical options available.
  • Pre-operative tests and evaluations are done to ensure the patient is a suitable candidate for surgery.
  • Patient may undergo counseling or education on what to expect before, during, and after the surgery.
  • Patient may need to stop taking certain medications or adjust their diet in preparation for the surgery.

After the laparoscopic hysterectomy:

  • Patient is monitored in the recovery room immediately after surgery.
  • Patient may experience some pain and discomfort, which can be managed with pain medication.
  • Patient may need to stay in the hospital for a day or two for monitoring and recovery.
  • Patient will have follow-up appointments with their gynecologist to monitor their healing and discuss any post-operative concerns.
  • Patient may need to take it easy and avoid heavy lifting or strenuous activities for a few weeks following the surgery.
  • Patient will gradually resume normal activities as they recover and may experience improvements in their symptoms related to the condition that necessitated the hysterectomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with each method of hysterectomy (vNOTES, VH, TLH)?
  2. How long is the recovery time for each method?
  3. Will I need to stay in the hospital after the surgery, and if so, for how long?
  4. How will each method affect my future reproductive health or hormone levels?
  5. Are there any long-term effects or considerations I should be aware of with each method?
  6. How many of these procedures have you performed, and what is your experience with each method?
  7. What type of anesthesia will be used for the surgery, and what are the potential side effects?
  8. Will I have any restrictions or limitations on activities after the surgery?
  9. What is the cost difference between the vNOTES, VH, and TLH methods?
  10. Are there any specific reasons why one method may be more suitable for me than the others based on my individual health and medical history?

Reference

Authors: Mollahüseyinoğlu Küllaç F, Özdemir AZ, Yildiz Ç. Journal: Medicine (Baltimore). 2024 Dec 13;103(50):e40881. doi: 10.1097/MD.0000000000040881. PMID: 39686461