vNOTES sentinel nodes removal from a remaining cervix.

This video demonstrates the feasibility of the sentinel lymph node technique via the vNOTES (vaginal Natural Orifices Transluminal Endoscopic Surgery) approach in patients who underwent subtotal hysterectomy for malignant neoplasia. The prior removal of the uterine corpus does not hinder the identification of sentinel lymph nodes when ICG is injected into the cervix. The surgical procedure involves positioning the patient in the gynecologic position, injecting ICG, and performing vaginal wall incisions to excise the sentinel lymph nodes bilaterally. Subsequently, the cervix is removed, followed by omentectomy, ureter identification, and excisional biopsy of suspicious lesions. In conclusion, the sentinel node technique works for patients who underwent previous subtotal hysterectomy. Furthermore, it is possible to perform it through vNOTES.