Abstract
<h3>Study Objective</h3> To demonstrate vaginal NOTES under the hood technique of hysterectomy in an obese patient. <h3>Design</h3> Stepwise description of the technique with narrated video. <h3>Setting</h3> Minimally invasive gynecological surgery department with experience in vNOTES at a tertiary care private hospital. <h3>Patients or Participants</h3> A 56-year-old female with post menopausal bleeding and simple atypical endometrial hyperplasia. She was nulliparous with a non-descending cervix and narrow vagina. Her BMI was 39.6 (Obesity grade 2). <h3>Interventions</h3> Vaginally assisted NOTES hysterectomy with bilateral salpingo-oophorectomy using a wet surgical mop. <h3>Measurements and Main Results</h3> The duration of the surgery was 51 minutes. The blood loss was about 15 ml. There were no intraoperative and postoperative complications. The patient was discharged on day two. <h3>Conclusion</h3> The hood made of a surgical mop retracts and protects the bowel and other viscera while hysterectomy is performed 'under the hood' using an energy device. This technique appears feasible and particularly helpful in an obese patient where the obliteration of space due to viscera is more common.
Published Version
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