Vaginal Natural Orifice Transluminal Endoscopic Surgery in Minimally Invasive Gynecologic Surgery.

Lerner, Veronica; Ulrich, Amanda; Chen, Chi Chiung Grace; Baekalandt, Jan · Obstet Gynecol · 2026

review · Level V

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Abstract

As vaginal hysterectomy rates continued to decline, vNOTES (vaginal natural orifice transluminal endoscopic surgery) emerged. vNOTES offers the advantage of combining the benefits of laparoscopy with improved visualization, instrumentation, and hemostasis with the vaginal route. In this review, we describe the vNOTES technique in gynecologic surgical procedures, review available evidence, and discuss future directions.

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