{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T09:20:13Z","timestamp":1792747213703,"version":"4.5.0"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare adnexectomy by vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) versus laparoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Parallel group, 1:1 single\u2010centre single\u2010blinded randomised trial, designed as non\u2010inferiority study with a margin of 15%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Belgian teaching hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Non\u2010pregnant non\u2010virgin women with an intact uterus and without obliteration of the pouch of Douglas scheduled to undergo removal of an adnexal mass assessed to be benign on ultrasound by IOTA criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomisation to laparoscopy (control group) or vNOTES (experimental group). Stratification according to adnexal size. Blinding of participants and outcome assessors by sham incisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcome measure was adnexectomy by the allocated technique. Secondary outcomes included duration of surgery, pain scores and analgesics used, quality of life and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We randomly assigned 67 participants (34 to the vNOTES group and 33 to the laparoscopy group). The primary end point was always reached in both groups: there were no conversions. We performed a sensitivity analysis for the primary outcome, assuming one conversion in the vNOTES group and no conversions in the laparoscopy group: the one\u2010sided 95% upper limit for the differences in proportions of conversion was estimated as 13%, which is below the predefined non\u2010inferiority margin of 15%. The secondary outcomes demonstrated a shorter duration of surgery, lower pain scores, lower total dose of analgesics and a trend for more adverse events in the vNOTES group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>vNOTES is non\u2010inferior to laparoscopy for a successful adnexectomy without conversion. vNOTES allowed shorter operating times and less postoperative pain but there was a trend for more adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.16838","type":"journal-article","created":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T13:53:40Z","timestamp":1625925220000},"page":"1782-1791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":92,"title":["Adnexectomy by vaginal Natural Orifice Transluminal Endoscopic Surgery versus laparoscopy: results of a first randomised controlled trial (NOTABLE trial)"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8344-8622","authenticated-orcid":false,"given":"J","family":"Baekelandt","sequence":"first","affiliation":[{"name":"Department of Gynaecology Imelda Hospital Bonheiden Belgium"},{"name":"Department of Development and Regeneration Faculty of Medicine Group Biomedical Sciences KU Leuven\u2010University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PA","family":"De Mulder","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Imelda Hospital Bonheiden Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Le Roy","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Imelda Hospital Bonheiden Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Clinical and Experimental Endocrinology KU Leuven\u2010University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Laenen","sequence":"additional","affiliation":[{"name":"Leuven Biostatistics and Statistical Bioinformatics Centre (L\u2010BioStat) KU Leuven\u2010University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Enzlin","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Interfaculty Institute for Family and Sexuality Studies KU Leuven\u2010University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Morlion","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences Section\u00a0Anaesthesiology &amp; Algology KU Leuven\u2010University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Weyers","sequence":"additional","affiliation":[{"name":"Universitaire Vrouwenkliniek University Hospital Gent Gent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"BWJ","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University Clayton Vic. Australia"},{"name":"Aberdeen Centre for Women's Health Research School of Medicine Medical Sciences and Nutrition University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJA","family":"Bosteels","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Imelda Hospital Bonheiden Belgium"},{"name":"Department of Development and Regeneration Faculty of Medicine Group Biomedical Sciences KU Leuven\u2010University of Leuven Leuven Belgium"},{"name":"Universitaire Vrouwenkliniek University Hospital Gent Gent Belgium"},{"name":"The Centre for Evidence\u2010based Medicine Cochrane Belgium Academic Centre for General Practice CEBAM KU Leuven\u2010University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2011.10.034"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15504"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018059"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c6839"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.118012"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00003.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2015.05.015"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c186"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.10.059"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61116-8"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10564"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cphy.c150049"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200010000-00038"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.11.030"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16838","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.16838","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16838","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T10:41:17Z","timestamp":1693219277000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.16838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,27]]},"references-count":15,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/1471-0528.16838"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.16838","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,27]]},"assertion":[{"value":"2021-05-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}