{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:52:12Z","timestamp":1792050732536,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Tubal ligation is a common permanent contraception method. Vaginal natural orifice transluminal endoscopic surgery (vNOTES) offers a scarless alternative to laparoscopy, but comparative evidence for interval tubal ligation is limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare surgical outcomes and recovery between vNOTES and conventional laparoscopic tubal ligation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Retrospective cohort at a tertiary center (August 2024\u2013May 2025). Women aged 30\u201350 seeking permanent contraception with ASA \u2264\u20093 were included. Exclusions: prior pelvic surgery or known pelvic pathology, salpingectomy or non\u2010contraceptive indications (e.g., hydrosalpinx), concomitant procedures, incomplete records. Patients were grouped by technique: vNOTES (\n n<\/jats:italic>\n =\u200920) or laparoscopy (\n n<\/jats:italic>\n =\u200927). Outcomes: operative time, hospital stay, time to mobilization, analgesia use, \u0394hemoglobin\/\u0394hematocrit, complications. Tests: t\u2010test\/Mann\u2013Whitney, Chi\u2010square\/Fisher; effect sizes (Cohen's d) and 95% CIs reported (\n \u03b1<\/jats:italic>\n =\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Baseline demographics were comparable. Operative time did not differ (mean difference \u22123.77 min, 95% CI \u22129.70 to 2.15;\n p<\/jats:italic>\n =\u20090.199; d = \u22120.32). vNOTES was associated with shorter hospitalization (\u22123.40 h, 95% CI \u22126.51 to \u22120.29;\n p<\/jats:italic>\n =\u20090.033; d\u2009=\u20090.47), earlier mobilization (\u22120.80 h, 95% CI \u22121.27 to \u22120.33;\n p<\/jats:italic>\n <\u20090.001; d\u2009=\u20090.94), and lower postoperative analgesia use (\u22121.05 doses, 95% CI \u22121.48 to \u22120.63;\n p<\/jats:italic>\n <\u20090.001; d\u2009=\u20091.55). Changes in hemoglobin and hematocrit were similar (both\n p<\/jats:italic>\n >\u20090.40). One vNOTES case required conversion to laparoscopy due to adhesions; no conversions occurred in the laparoscopy group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n vNOTES and laparoscopy are both safe for interval tubal ligation. vNOTES confers clinically meaningful recovery advantages\u2014shorter hospitalization, faster mobilization, and reduced analgesic need\u2014while maintaining comparable operative time and blood loss surrogates. These findings support vNOTES as a promising, patient\u2010centered alternative.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ases.70236","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T08:38:17Z","timestamp":1768293497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Scarless Sterilization? A Comparative Study of Vaginal Notes and Laparoscopic Tubal Ligation"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-1731","authenticated-orcid":false,"given":"Ay\u015fe Bet\u00fcl","family":"Albayrak Denizli","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Medistate Kavac\u0131k Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-4899","authenticated-orcid":false,"given":"Eralp","family":"Bulutlar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Zeynep K\u00e2mil Women's and Children's Disease Training and Research Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3358-6250","authenticated-orcid":false,"given":"Gizem","family":"Boz \u0130zceyhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Zeynep K\u00e2mil Women's and Children's Disease Training and Research Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5497-4490","authenticated-orcid":false,"given":"Narin Ece","family":"Rol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Zeynep K\u00e2mil Women's and Children's Disease Training and Research Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7107-9719","authenticated-orcid":false,"given":"Sad\u0131k","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Zeynep K\u00e2mil Women's and Children's Disease Training and Research Hospital Istanbul 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