{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:47:26Z","timestamp":1790736446768,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"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":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to assess the peri\u2010 and postoperative outcomes of the vNOTES hysterectomy in the Netherlands during implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Nationwide cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>vNOTES hysterectomies performed in the Netherlands by 15 hospitals since the implementation of the technique, from August 2019 to September 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>673 patients undergoing vNOTES hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Descriptive data are presented as frequencies with percentage or mean with range. Logistic regression was used to assess the risk of conversions\/complications per BMI group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Peri\u2010 and postoperative outcomes such as operating time, conversions, and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean operating time was 67.4\u2009min (range 24\u2013210). There were 37 (5.5%) conversions and 94 (15.5%) complications. Nineteen (2.8%) complications were perioperative, and 75 (12.7%) postoperative. Ten (1.5%) of the perioperative complications were classified as Clavien\u2010Dindo (CD) 1, and nine (1.3%) as CD3. Postoperatively, 18 patients (3.1%) had a reintervention (<jats:italic>N<\/jats:italic>\u2009=\u200917 CD3, <jats:italic>N<\/jats:italic>\u2009=\u20091 CD4), and two (0.3%) patients were admitted to the intensive care unit (CD4). The mean blood loss was 127\u2009mL (range 50\u20132000), and 220 (37%) of patients were discharged the same day.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This large nationwide cohort study during implementation of the vNOTES hysterectomy demonstrates the safety and feasibility of this upcoming technique, reporting on a short surgery duration and a similar complication percentage compared to other methods of hysterectomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18307","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T07:29:30Z","timestamp":1752823770000},"page":"1810-1816","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Introduction of the <scp>vNOTES<\/scp> Hysterectomy in The Netherlands: A Nationwide Cohort Study"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9608-5471","authenticated-orcid":false,"given":"Hilde M. M.","family":"Sluijter","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics Catharina Hospital Eindhoven  Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilse P. W.","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Zuyderland Medical Centre Heerlen  Heerlen Limburg the Netherlands"},{"name":"GROW School for Oncology and Reproduction, Maastricht University Medical Centre  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Henschen","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Zuyderland Medical Centre Heerlen  Heerlen Limburg the Netherlands"},{"name":"GROW School for Oncology and Reproduction, Maastricht University Medical Centre  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"van Alphen","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Flevo Hospital  Almere the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Ebisch","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Canisius Wilhelmina Hospital  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen S.","family":"Kok","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Alrijne Hospital  Leiderdorp the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Labrie","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Spaarne Gasthuis  Haarlem the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne A. L.","family":"van Leijsen","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Maxima Medical Centre  Veldhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9le L. M.","family":"Oei","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Bernhoven Hospital  Uden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisette W.","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics OLVG  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda M.","family":"Pijlman","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Jeroen Bosch Hospital  's Hertogenbosch the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Marko","family":"Sikkema","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Ziekenhuisgroep Twente  Almelo the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu Y.","family":"van der Vlist","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Albert Schweitzer Hospital  Dordrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G. J. A.","family":"Voogdt","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Haga Hospital  Den Haag the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Noordwest Hospital Group  Alkmaar the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorien M.","family":"Woolderink","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Martini Hospital  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol A. 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