Vaginal Natural Orifice Transluminal Endoscopic Surgery (VNOTES) is an innovative surgical technique that uses the vagina to access the abdominal cavity during a hysterectomy. This minimally invasive approach has gained popularity in recent years due to its numerous advantages over traditional surgical methods, making it an attractive option for patients and healthcare providers alike.
Steve Domnitz, MD, OB/GYN, Chilton Medical Center, who has been in practice for over 35 years, performs the VNOTES procedure on patients who have excessive bleeding during and after menopause, have fibroid tumors or have chronic pain. “Studies have shown that VNOTES should be the procedure of choice for any patient who is a candidate and is endorsed by the American College of Obstetricians and Gynecologists (ACOG) and the American Association of Gynecologic Laparoscopists (AAGL).”
During the VNOTES procedure, the surgeon uses advanced endoscopic instruments introduced through the vaginal canal. By utilizing the natural opening of the vagina, surgeons can access the pelvic and abdominal regions without the need for external incisions. This technique is particularly beneficial for gynecological surgeries, including hysterectomies, ovarian cystectomies and endometriosis excision.
Benefits of VNOTES for the patient include:
- Minimized Scarring: Since VNOTES is performed entirely through the vaginal canal, patients experience no visible scarring, leading to better cosmetic outcomes.
- Reduced Pain and Discomfort: Patients typically report less postoperative pain compared to traditional abdominal surgeries. The lack of external incisions reduces tissue trauma, resulting in a more comfortable recovery.
- Faster Recovery: Most patients can return to their normal activities within a week, significantly shortening the recovery period compared to conventional surgical methods.
- Lower Risk of Complications: The minimally invasive nature of VNOTES is associated with a reduced risk of surgical complications, such as infections and longer recovery times.
- Improved Surgical Outcomes: Early studies suggest that VNOTES may lead to fewer complications and shorter hospital stays, contributing to enhanced patient satisfaction.
Dr. Domnitz added that there are several advantages for the surgeon, including less chronic pain due to being able to perform the procedure from a sitting position rather than standing and time management is improved because of the shorter length of the procedure.
“While VNOTES offers advantages, it may not be suitable for all patients,” Dr. Domnitz explained. “Factors such as the complexity of the condition, the presence of previous pelvic surgeries or anatomical considerations may influence the decision to proceed with this approach. It is essential for patients to have a thorough discussion with their healthcare provider to determine the most appropriate surgical option for their needs.”
If your patients are considering VNOTES, refer them to Dr. Domnitz to determine if they are candidates and to discuss the procedure. He can be reached at 973-831-1800.
About Steve Domnitz, MD
Dr. Domnitz received his medical degree from the George Washington School of Medicine & Health Sciences and completed a residency at the New York Downtown Hospital.
He is board certified in Obstetrics and Gynecology and is a fellow of the American Board of Obstetrics and Gynecology and a consultant with the Endometriosis Association.