Abstract
<h3>Study Objective</h3> The vNOTES approach offers better visualization, and thus better access to the deep pelvic structures in performance of high uterosacral ligament suspension. <h3>Design</h3> This video demonstrates a hybrid of traditional vaginal and laparoscopic technique through the natural vaginal orifice to perform reduction of pelvic organ prolapse. <h3>Setting</h3> Community Hospital. <h3>Patients or Participants</h3> 57-yo G1P1 with Stage 3 uterine prolapse and cystocele. <h3>Interventions</h3> transvaginal natural orifice transluminal endoscopic surgical (vNOTES) hysterectomy and high uterosacral ligament suspension. <h3>Measurements and Main Results</h3> Successful reduction of stage 3 uterine prolapse and cystocele to stage 0 following a high uterosacral ligament suspension through a vNOTES approach. <h3>Conclusion</h3> vNOTES offers an improved approach to high uterosacral ligament suspension over traditional vaginal and laparoscopic approaches by offering better visualization and access to the deep pelvic structures.
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