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Retrieval was facilitated by transvaginal cold knife morcellation in the Pouch of Douglas under direct vision following vNOTES assistance without abdominal incisions. This is the first time vNOTES has been described for excision of solid ovarian tumors of these dimensions; the authors discuss its advantages compared to conventional laparoscopy, together with challenges of retrieving a solid lesion through a posterior colpotomy incision.<\/jats:p>","DOI":"10.1111\/ases.70136","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T23:40:08Z","timestamp":1755646808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>vNOTES<\/scp>\n                    Assisted Vaginal Bilateral Salpingo\u2010Oophorectomy in Postmenopausal Women With Large Ovarian Fibroma"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-5968","authenticated-orcid":false,"given":"Wai","family":"Yoong","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology North Middlesex University Hospital  London 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