vNOTES hysterectomy
Musin I.I., Berg E.A., Yashchuk A.G., Molokanova A.R., Murtazina G.Kh., Imelbaeva A.G., Kuznetsova R.R., Khusnutdinova M.N.
Vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy is the most modern approach to this procedure, involving a transvaginal hysterectomy performed using an endoscope.
Objective: To evaluate the effectiveness of vNOTES hysterectomy compared with the traditional laparoscopic approach based on intraoperative and postoperative parameters.
Materials and methods: This study included 200 patients aged 45–75 years who had undergone hysterectomy. In the VEH group, a hysterectomy was performed using the vNOTES approach, whereas in the LH group, a laparoscopic hysterectomy was performed. The study cohort was analyzed for anthropometric and anamnestic characteristics, obstetric and gynecological history, total operative time, time to hysterectomy, total blood loss, surgical table angle, extension of the surgical procedure, intraoperative and postoperative complications, and number of days until hospital discharge.
Results: The groups were comparable in terms of anthropometric parameters, age, number of pregnancies, parity, total operative time, blood loss, hospital stay, and absolute number of complications. The VEH group showed statistically significant advantages in terms of shorter time to hysterectomy -17.0 (95% CI 0.54–1.12; р-value<0.001; dCohen=0.83); lower maximum CO2 pressure 2,0 (95% CI 1.06–1.68; р-value<0.001;
dCohen=1.37); a smaller operating table inclination -10.0 (95% CI 2,81–3,65; р-value<0,001; dCohen=3,2, shorter time of vaginal stump suturing -8.0 (95% CI, 2.52–3.32; p-value<0.001; dCohen= 2.92) and reduction of postoperative pain at 6 and 24 hours after surgery -1.0 (95% CI 0.24–0.8; p-value<0.001; dCohen=0.52) and -1.0 (95% CI 0.26–0.82; p-value<0.001; dCohen=0.54), respectively. The VEH group also had the advantage of not requiring an incision on the anterior abdominal wall, which had a beneficial effect in the postoperative period.
Conclusion: The results demonstrate the advantages of the vNOTES approach over the traditional laparoscopic approach to hysterectomy.
Authors' contributions: Musin I.I. – conception and design of the study, data collection; Berg E.A. – drafting of the manuscript, statistical analysis, data collection; Yashchuk A.G. – conception and design of the study, drafting of the manuscript, approval of the final version of the article; Molokanova A.R., Murtazina G.Kh. – editing of the manuscript, data collection; Imelbaeva A.G. – editing of the manuscript; Kuznetsova R.R., Khusnutdinova M.N. – data collection.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the Bashkir State Medical University, Ministry of Health of Russia.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Musin I.I., Berg E.A., Yashchuk A.G., Molokanova A.R., Murtazina G.Kh.,
Imelbaeva A.G., Kuznetsova R.R., Khusnutdinova M.N. vNOTES hysterectomy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (3): 95-103 (in Russian)
https://dx.doi.org/10.18565/aig.2025.332
Keywords
hysterectomy
vNOTES
vaginal endoscopic hysterectomy
laparoscopic hysterectomy
minimally invasive gynecology
comparative analysis of operations
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Received 17.11.2025
Accepted 29.01.2026
About the Authors
Ilnur I. Musin, Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia, 450008, Russia, Ufa, Lenin str., 3, +7(917)467-10-64, ilnur-musin@yandex.ru, https://orcid.org/0000-0001-5520-5845Edward A. Berg, PhD, Associate Professor, Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia, 450008, Russia, Ufa, Lenin str., 3, +7(927)337-90-03, nucleardeer@gmail.com, https://orcid.org/0000-0002-2028-7796
Alfiya G. Yashchuk, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia, 450008, Russia, Ufa, Lenin str., 3, +7(347)264-96-50, alfiya_galimovna@mail.ru, https://orcid.org/0000-0002-6725-2603
Angella R. Molokanova, PhD, Assistant Lecturer, Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia,
450008, Russia, Ufa, Lenin str., 3, +7(917)349-04-72, angella1210@mail.ru, https://orcid.org/0000-0003-1115-6775
Gulnaz H. Murtazina, PhD, Associate Professor, Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia,
450008, Russia, Ufa, Lenin str., 3, +7(917)349-04-72, karamelka5@inbox.ru, https://orcid.org/0000-0001-9529-3747
Albina G. Imelbaeva, PhD, Associate Professor, Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia,
450008, Russia, Ufa, Lenin str., 3, +7(917)349-04-72, albina220588@gmail.com, https://orcid.org/0000-0002-0558-1364
Regina R. Kuznetsova, resident, Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia, 450008, Russia, Ufa,
Lenin str., 3, +7(917)421-87-84, regina18402@gmail.com, https://orcid.org/0009-0000-9139-5375
Mariia N. Khusnutdinova, resident, Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia, 450008, Russia, Ufa,
Lenin str., 3, +7(982)283-00-95, maria.medartz@gmail.com, https://orcid.org/0009-0006-7806-0013
