Systematic Review and Meta-Analysis on Hysterectomy by Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Compared to Laparoscopic Hysterectomy for Benign Indications

Susanne Housmans; Nargis Noori; Supuni Kapurubandara; Jan J A Bosteels; Laura Cattani; Ibrahim Alkatout; Jan Deprest; Jan Baekelandt

doi:10.3390/jcm9123959

Systematic Review and Meta-Analysis on Hysterectomy by Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Compared to Laparoscopic Hysterectomy for Benign Indications

J Clin Med. 2020 Dec 7;9(12):3959. doi: 10.3390/jcm9123959.

Authors

Susanne Housmans^{1

2}, Nargis Noori^{3

4}, Supuni Kapurubandara^{3

4

5}, Jan J A Bosteels^{1

6}, Laura Cattani^{1

2}, Ibrahim Alkatout⁷, Jan Deprest^{1

2}, Jan Baekelandt^{1

6}

Affiliations

¹ Department of Development and Regeneration, Faculty of Medicine, Group Biomedical Sciences, KU Leuven, 3000 Leuven, Belgium.
² Department of Obstetrics and Gynaecology, University Hospitals Leuven, 3000 Leuven, Belgium.
³ Department of Obstetrics and Gynaecology, Westmead Hospital, Westmead 2145, Australia.
⁴ Sydney West Advanced Pelvic Surgery (SWAPS), Bella Vista 2153, Australia.
⁵ Department of Obstetrics and Gynaecology, University of Sydney (USYD), Sydney 2052, Australia.
⁶ Department of Obstetrics and Gynaecology, Imelda Hospital, 2820 Bonheiden, Belgium.
⁷ Kiel School of Gynaecological Endoscopy, Department of Gynaecologiy and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.

Abstract

(1) Objective: We aimed to report an update of the systematic review and meta-analysis by Baekelandt et al. (2016). (2) Method: We followed PRISMA guidelines to perform this systematic review. We searched MEDLINE, EMBASE, CENTRAL and additional sources and aimed to retrieve randomised controlled trials (RCTs), controlled clinical trials (CCTs) and prospective/retrospective cohort studies in human subjects that allowed direct comparison of vNOTES to laparoscopy. (3) Results: Our search yielded one RCT and five retrospective cohort trials. Pooled analysis of two subgroups showed that, compared to conventional laparoscopy, vNOTES is equally effective to successfully remove the uterus in individuals meeting the inclusion criteria. vNOTES had significantly lower values for operation time, length of stay and estimated blood loss. There was no significant difference in intra- and postoperative complications, readmission, pain scores at 24 h postoperative and change in hemoglobin (Hb) on day 1 postoperative.

Keywords: NOTES; hysterectomy; laparoscopy; meta-analysis; minimally invasive; systematic review.

Publication types

Review