Frontiers in surgery · 2026
Uterine-Sparing vNOTES vs. laparoscopic lateral suspension for pelvic organ prolapse repair: a prospective comparative study of feasibility and early outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sengi Abdurrahman, Duran Mehmet Nuri, Pekgül Mayıs Jinda, Peker Nurullah
Аннотация
BACKGROUND: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) represents a minimally invasive uterus-preserving technique for apical prolapse repair. Comparative data with laparoscopic lateral suspension are scarce. This study aimed to evaluate perioperative performance, anatomical correction, and functional outcomes of both approaches.
METHODS: In this prospective cohort, 100 women with symptomatic anterior-apical pelvic organ prolapse (POP-Q ≥ II) underwent either vNOTES lateral suspension (n = 50) or LLS (n = 50). Perioperative metrics, POP-Q parameters, and validated functional questionnaires (POPDI-6, UDI-6, CRADI-8) were recorded preoperatively and at 3 and 6 months. Complications and recurrence were assessed. Radar visualization was used to illustrate POP-Q approximation relative to expected anatomical contours.
RESULTS: Both techniques provided successful anterior-apical correction. Operative time (60.4 ± 11.2 vs. 90.7 ± 8.4 min; p < 0.001) and length of hospital stay (1.32 ± 0.59 vs. 1.98 ± 0.65 days; p < 0.001) were significantly shorter with vNOTES. POP-Q measurements favored vNOTES at 6 months for Ba and Bp (p < 0.001), whereas point C and total vaginal length were comparable. Functional outcomes demonstrated lower POPDI-6 and UDI-6 scores in the vNOTES cohort at both follow-ups (p < 0.05). No mesh exposures occurred. Complication rates were low and did not differ significantly. Radar visualization demonstrated more uniform postoperative approximation in the vNOTES group.
CONCLUSION: Both vNOTES and laparoscopic lateral suspension achieved effective uterus-preserving prolapse repair with favorable short-term anatomical and functional results. vNOTES provided faster perioperative recovery and greater functional symptom improvement without compromising safety. Extended follow-up will clarify durability.
METHODS: In this prospective cohort, 100 women with symptomatic anterior-apical pelvic organ prolapse (POP-Q ≥ II) underwent either vNOTES lateral suspension (n = 50) or LLS (n = 50). Perioperative metrics, POP-Q parameters, and validated functional questionnaires (POPDI-6, UDI-6, CRADI-8) were recorded preoperatively and at 3 and 6 months. Complications and recurrence were assessed. Radar visualization was used to illustrate POP-Q approximation relative to expected anatomical contours.
RESULTS: Both techniques provided successful anterior-apical correction. Operative time (60.4 ± 11.2 vs. 90.7 ± 8.4 min; p < 0.001) and length of hospital stay (1.32 ± 0.59 vs. 1.98 ± 0.65 days; p < 0.001) were significantly shorter with vNOTES. POP-Q measurements favored vNOTES at 6 months for Ba and Bp (p < 0.001), whereas point C and total vaginal length were comparable. Functional outcomes demonstrated lower POPDI-6 and UDI-6 scores in the vNOTES cohort at both follow-ups (p < 0.05). No mesh exposures occurred. Complication rates were low and did not differ significantly. Radar visualization demonstrated more uniform postoperative approximation in the vNOTES group.
CONCLUSION: Both vNOTES and laparoscopic lateral suspension achieved effective uterus-preserving prolapse repair with favorable short-term anatomical and functional results. vNOTES provided faster perioperative recovery and greater functional symptom improvement without compromising safety. Extended follow-up will clarify durability.