{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:38:58Z","timestamp":1792024738058,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The current standard treatment for endometrial cancer is a laparoscopic hysterectomy with adnexectomies and bilateral sentinel node resection. A retroperitoneal vNOTES sentinel node resection has several theoretical potential advantages. These include being less invasive, leaving no visible scars, operating without Trendelenburg, and therefore offering the anesthetic advantage of easier ventilation in obese patients and following the natural lymph node trajectory from caudally to cranially and therefore a lower risk of missing the sentinel node. The aim of this study is to determine the feasibility of a retroperitoneal vNOTES approach to sentinel lymph node dissection for staging of endometrial cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>A prospective multicenter case series was performed in four hospitals. A total of 64 women with early\u2010stage endometrial carcinoma suitable for surgical staging with sentinel lymph node removal were operated via a transvaginal retroperitoneal vNOTES approach. The paravesical space was entered through a vaginal incision after injecting the cervix with indocyanine green. A vNOTES port was placed into this space and insufflation of the retroperitoneum was performed. Sentinel lymph nodes were identified bilaterally using near\u2010infrared light followed by endoscopic removal of these nodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 64 women with early\u2010stage endometrial cancer underwent sentinel lymph node removal by retroperitoneal vNOTES technique. All patients also underwent subsequent vNOTES hysterectomy and bilateral salpingo\u2010oophorectomy. The median age was 69.5\u2009years, median total operative time was 126\u2009min and the median estimated blood loss was 80\u2009mL. In 97% of the cases bilateral sentinel nodes could be identified. A total of 60 patients had negative sentinel nodes, three had isolated tumor cells and one had macroscopically positive sentinel nodes. No complications with sequel occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This prospective multicenter case series demonstrates the feasibility of the vNOTES approach for identifying and removing sentinel lymph nodes in women with endometrial carcinoma successfully and safely. vNOTES allows sole transvaginal access with exposure of the entire retroperitoneal space, following the natural lymph trajectory caudally to cranially, and without the need for a Trendelenburg position.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14843","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T05:05:36Z","timestamp":1713243936000},"page":"1311-1317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["vNOTES retroperitoneal sentinel lymph node dissection for endometrial cancer staging: First multicenter, prospective case series"],"prefix":"10.1111","volume":"103","author":[{"given":"Jan","family":"Baekelandt","sequence":"first","affiliation":[{"name":"Department of Gynecology Imelda Hospital  Bonheiden Belgium"},{"name":"Department of Development and Regeneration, Faculty of Medicine Group Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2786-0951","authenticated-orcid":false,"given":"Astrid","family":"Jespers","sequence":"additional","affiliation":[{"name":"Department of Gynecology Imelda Hospital  Bonheiden Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sion Hospital  Sion Switzerland"},{"name":"Department of Pediatrics, Gynecology and Obstetrics Geneva University Hospital  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levon","family":"Badiglian\u2010Filho","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology AC Camargo Cancer Center  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute for Clinical Sciences Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linus","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Nuvance Health, Larner College of Medicine University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oudai","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Gynecology Epsom and St Helier University  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Burnett","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecologic Oncology University of Arkansas for Medical Sciences  Little Rock Arkansas USA"},{"name":"The Winthrop P Rockefeller Cancer Institute University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1412","article-title":"Seminar endometrial","volume":"399","author":"Crosbie 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