Is the scar-less hysterectomy with Natural Orifice Transluminal Endoscopic Surgery (NOTES) the future of benign gynecological surgery? A Review of the literature

As the tide advances towards minimally invasive surgical approaches which are favourable over open methods in terms of patient analgesia requirements and recovery time, Natural Orifice Transluminal Endoscopic Surgery (NOTES) has emerged as a technique within gynaecology which uses laparoscopic instruments and methods without the need for abdominal incisions. NOTES surgery has been conducted within gynecology via a vaginal colpotomy to perform procedures such as adnexectomy, hysterectomy, myomectomy and urogynecological procedures. This review summarises the available literature data on NOTES surgery with preliminary results showing reduced postoperative pain, improved cosmesis, and the potential for faster patient recovery and hospital discharge as compared to traditional methods. Larger, more robust data is needed to truly compare the efficacy of gynecological NOTES over traditional methods, however initial literature suggests this may be a promising innovation emerging in the field of gynecology.