Résumé
vNOTES is an endoscopic surgery through vaginal access.At present,vNOTES is mainly applied to benign gynecological diseases,and great attention was paid to it because of its advantage of fast recovery,cosmetic results and mild incision pain.This study was the discussion about surgical indication,methods,advantages,problems and surgical techniques in benign gynecological diseases by vNOTES,and the clinical application value and feasibility of vNOTES were also analyzed.
Résumé
Transvaginal NOTES surgery,as an emerging minimally invasive surgical technique,is widely used in gynecology disease.However,there are some difficulties in clinical application. This article discusses the indications and contraindications of transvaginal NOTES,the difficulties and countermeasures in the establishment of the access platform,the exposure problems of the surgical visual field,the complications encountered during the operation and their treatment,and infection prevention.
Résumé
OBJECTIVE: To study the efficacy of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)sacrocolpopexy in the treatment of pelvic organ prolapse(POP).METHODS: From June 2017 to September 2018,33 POP patients who underwent vNOTES sacrocolpopexy in the Third Affiliated Hospital of Guangzhou Medical University were collected.The operative time,blood loss and postoperative complications were recorded to evaluate the safety of the operation.After regular follow-up,POP-Q was used to objectively evaluate the effect of surgery,and PFIQ-7 was used to evaluate the recovery effect.RESULTS: In this group,3 of 33 cases were converted to transumbilical laparoscopy,and in the remaining 30 cases the surgery was successfully completed.The operation time was(184.97±41.91)min,and mean estimated blood loss was(28.33±18.77)mL.No complications such as exposure or infection of mesh were found after operation.The POP-Q indicators were significantly improved in 1,3,6 months after surgery(P<0.05),and the quality of life was better after operation than before(P<0.05).CONCLUSION: vNOTES is a feasible and safe approach for sacrocolpopexy with positive short-term efficacy in the treatment of POP.