VNOTES Prolapse

vNOTES (Scarless Surgery) in Pelvic Organ Prolapse – Clinical Guide

What is vNOTES?

vNOTES (vaginal natural orifice transluminal endoscopic surgery) is a minimally invasive surgical method performed through the vaginal route, leaving no incision scar on the abdomen.

Use in Pelvic Organ Prolapse

vNOTES can be used especially in apical prolapse (uterine/vaginal vault prolapse) surgery. It provides both diagnostic and therapeutic advantages.

In Which Prolapses Can It Be Applied?

• Uterine prolapse
• Vaginal vault prolapse
• Enterocele
• Combined pelvic organ prolapses

Performed Surgeries

• vNOTES hysterectomy + apical suspension
• vNOTES uterosacral ligament suspension
• vNOTES sacrocolpopexy (in selected cases)
• Combined anterior/posterior repair

Advantages

• No abdominal incision (scarless surgery)
• Less pain
• Faster recovery
• Shorter hospital stay
• Cosmetic advantage

Disadvantages

• High learning curve
• May not be suitable for every patient
• May be difficult in cases of severe adhesions

Who is it Suitable For?

• Those with moderate to severe pelvic organ prolapse
• Patients desiring minimally invasive surgery
• Patients with suitable anatomical structure

Who is it Not Suitable For?

• Extensive intra-abdominal adhesions
• Severe obesity (relative)
• Situations where vaginal access is difficult

Surgical Aim

To restore pelvic organs to their anatomical position and provide apical support

Clinical Reality

vNOTES is a modern technique increasingly used in pelvic floor surgery, providing successful outcomes with proper patient selection.

Conclusion

Scarless surgery with vNOTES is an effective treatment option for pelvic organ prolapse, offering high patient comfort.