{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:54:57Z","timestamp":1790578497767,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To compare Vaginal Hysterectomy (VH) with Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery (NOTES) hysterectomy (VANH) as a day\u2010care procedure.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Single\u2010blind, multicentre randomised controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Two Dutch non\u2010academic teaching hospitals.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n Women aged \u2265\u200918\u2009years undergoing hysterectomy for benign indications.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Women were randomised 1:2 (VH or VANH). Primary outcome was SDD. Secondary outcomes included operative time, rate of elective salpingectomies, intraoperative blood loss, complications (Clavien\u2013Dindo), pain scores (NRS) and analgesic use, post\u2010operative recovery (RI\u201010), and quality of life (EQ\u20105D\u20105L). Analyses were performed on an intention\u2010to\u2010treat basis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 113 patients were included in the analyses (\n n<\/jats:italic>\n \u2009=\u200942 VH, and\n n<\/jats:italic>\n \u2009=\u200971 VANH). SDD occurred significantly more frequently in the VANH group (87.3%) than VH group (71.4%; OR 2.76, 95% CI 1.04\u20137.25;\n p<\/jats:italic>\n \u2009=\u20090.04). VANH was associated with a significantly shorter operative time (median 55\u2009min versus 65\u2009min;\n p<\/jats:italic>\n \u2009=\u20090.005), less blood loss (median 50\u2009mL vs. 150\u2009mL;\n p<\/jats:italic>\n \u2009<\u20090.001) and more often elective opportunistic salpingectomy compared to VH (100% vs. 77.4%;\n p<\/jats:italic>\n \u2009=\u20090.008). NRS were significantly lower in the VANH group the first hour post\u2010operative (3 vs. 1,\n p<\/jats:italic>\n \u2009<\u20090.001). Post\u2010operative complications (VH 9.5% vs. VANH 15.5%;\n p<\/jats:italic>\n \u2009=\u20090.34), readmission (VH 4.8% vs. VANH 8.5%;\n p<\/jats:italic>\n \u2009=\u20090.47), analgesic use, recovery, and quality of life were not statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n VANH is a safe and effective alternative to VH, offering a higher likelihood of SDD, shorter operative time, reduced blood loss, and more often an elective salpingectomy, without increased complications or differences in pain, recovery, or quality of life.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.70260","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T08:45:12Z","timestamp":1778834712000},"page":"2035-2043","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vaginal Hysterectomy Versus Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery Hysterectomy; Results of a Randomised Controlled Trial"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9938-200X","authenticated-orcid":false,"given":"Ilse P. W.","family":"Bekkers","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics Zuyderland Medical Centre Heerlen Heerlen Limburg the Netherlands"},{"name":"GROW \u2013 Research Institute for Oncology and ReproductionMaastricht University Medical Centre+ Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floor R. M.","family":"Wintraecken","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Zuyderland Medical Centre Heerlen Heerlen Limburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol A. C.","family":"Smeets","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Zuyderland Medical Centre Heerlen Heerlen Limburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Damoiseaux","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Catharina Hospital Eindhoven Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques W. M.","family":"Maas","sequence":"additional","affiliation":[{"name":"GROW \u2013 Research Institute for Oncology and ReproductionMaastricht University Medical Centre+ Maastricht the Netherlands"},{"name":"Department of Obstetrics and Gynaecology Maastricht University Medical Centre+ Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huib A. A. M.","family":"van Vliet","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Catharina Hospital Eindhoven Eindhoven the Netherlands"},{"name":"Department of Human Structure and Repair University Gent Gent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine M. L. H.","family":"Wassen","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Zuyderland Medical Centre Heerlen Heerlen Limburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2019.07.014"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/GMIT.GMIT_62_18"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.08.023"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9123959"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2018.08.009"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10397-015-0904-6"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15504"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-014-0562-z"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.019"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003677.pub5"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10397-013-0781-9"},{"issue":"8","key":"e_1_2_12_13_1","article-title":"Surgical Approach to Hysterectomy for Benign Gynaecological Disease","volume":"8","author":"Pickett C. 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