Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Hysterectomy with Two Previous Renal Transplantations: The First Case in the Literature Two Renal Transplants.

This study demonstrates the feasibility of performing a Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) hysterectomy on a patient with a complex surgical history, including two renal transplants. The case involves a 42-year-old female presenting with persistent menorrhagia and hypermenorrhea, unresponsive to standard treatments, and diagnosed with adenomyosis and CIN3. A detailed, step-by-step procedure of the vNOTES technique is provided, marking the first video article to document vNOTES hysterectomy in such a medical context. The findings highlight vNOTES as a viable approach for treating refractory uterine bleeding and adenomyosis in patients with prior transplants, offering insights for young surgeons considering this minimally invasive technique in complex cases.