Hysterectomy using Vaginal Natural Orifice Transluminal Endoscopic surgery (vNOTES) compared with classic laparoscopic hysterectomy: a new advantageous approach? A systematic review on surgical outcomes

Introduction: Minimally invasive surgery aims to reduce surgical trauma and postoperative morbidity. Natural orifice transluminal endoscopic surgery (NOTES) is a safe and valid surgical option for hysterectomy. The present systematic review aims to compare hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) with laparoscopic hysterectomy in terms of efficacy, surgical outcomes, complications, and cost. Materials and methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It includes randomized controlled trials, controlled clinical trials, prospective or retrospec…