8154 Comparison of Surgical Outcomes of Hysterectomy by Vaginal Notes Versus Single-Port Access (SPA) Surgery

Abstract

<h3>Study Objective</h3> The objective of the present study is to compare the patient characteristics, operative details, and post-operative outcomes among patients who underwent vNOTES against those who underwent SPA laparoscopic surgery for benign gynecologic diseases. <h3>Design</h3> Prospective outcome study. <h3>Setting</h3> Tertiary university teaching hospital. <h3>Patients or Participants</h3> The patients who were planned to undergo vNOTES or SPA laparoscopic surgery between April 2020 and June 2021 were prospectively enrolled. The surgical method was determined by a single surgeon after the evaluation of imaging results and physical exams. Those who demonstrated favorable pelvic conditions without any evidence of adhesion were scheduled for vNOTES. <h3>Interventions</h3> vNOTES hysterectomy vs. SPA TLH. <h3>Measurements and Main Results</h3> A total of 33 patients underwent vNOTES hysterectomy while 40 patients received SPA laparoscopic hysterectomy. All surgeries were performed by one surgeon. The proportion of the patients who had history of vaginal delivery was significantly higher in the vNOTES group. The operative time for port installation was significantly longer in the vNOTES group, but the total operative time was shorter in the vNOTES group compared to the SPA group. The post-operative pain scores 12 hours after the operations were also significantly less in the vNOTES group. Other surgical information and immediate post-operative outcomes were comparable between the two groups. <h3>Conclusion</h3> The present study demonstrated that the early operative outcomes of vNOTES hysterectomy were comparable to those of SPA hysterectomy. It also highlights the importance of adequate patient selection when determining surgical methods based on imaging results and physical exams.