{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:40:27Z","timestamp":1772138427282,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although transvaginal natural orifice transluminal endoscopic surgery (NOTES) is gaining importance, knowledge on transvaginal NOTES procedures in gynecologic practice is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed at evaluating the feasibility and safety of performing hysterectomy and bilateral adnexectomy (or bilateral salpingectomy) via transvaginal NOTES using a self\u2010developed multichannel abdominal port and vaginal support ring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A prospective, single\u2010center, cohort pilot study was conducted from May to December 2017 in patients with benign uterine diseases or endometrial atypical hyperplasia or cervical intraepithelial neoplasia (<jats:italic>n<\/jats:italic>\u00a0=\u00a030) scheduled for laparoscopic hysterectomy. The procedure was performed using a self\u2010developed five\u2010channel port and a vaginal support ring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hysterectomy and bilateral adnexectomy (or bilateral salpingectomy) in all 30 cases (mean age: 51.43\u2009\u00b1\u20094.60\u2009years and body mass index: 23.42\u2009\u00b1\u20091.45\u2009kg\/m<jats:sup>2<\/jats:sup>) were successfully performed completely under transvaginal NOTES. Mean operation time was 95.90\u2009\u00b1\u200914.60\u2009minutes and mean blood loss during the procedure was 52.50\u2009\u00b1\u200919.20\u2009mL. Average weight of specimen was 79.97\u2009\u00b1\u200935.48\u2009g. Only one complication of bladder injury was noted and was rectified accordingly. Visual Analog Score (VAS) at first day after operation was 2.70\u2009\u00b1\u20090.72. After follow\u2010up for 4.50\u2009\u00b1\u20091.85\u2009months, all the patients' vaginal stump healed well without scar formation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study showed that use of multichannel abdominal port could make laparoscopic instruments easier to fix and operate wherein the vaginal support ring reduces the leakage of carbon dioxide pneumoperitoneum. There was no scar on the abdomen and VAS was much lower. This study also demonstrated cosmetic benefits and rapid postoperative recovery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14752","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T00:58:54Z","timestamp":1619053134000},"page":"2521-2528","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Hysterectomy and bilateral adnexectomy using transvaginal natural orifice transluminal endoscopic surgery: The role of <scp>multichannel<\/scp> abdominal <scp>PORT<\/scp> and vaginal support ring"],"prefix":"10.1111","volume":"47","author":[{"given":"Junji","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynecology &amp; Obstetrics Peking Union Medical College Hospital, Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Gynecology &amp; Obstetrics Peking Union Medical College Hospital, Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhua","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Gynecology &amp; Obstetrics Peking Union Medical College Hospital, Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gynecology &amp; Obstetrics Peking Union Medical College Hospital, Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinghe","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Gynecology &amp; Obstetrics Peking Union Medical College Hospital, Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gynecology &amp; Obstetrics Peking Union Medical College Hospital, Chinese Academy of Medical Sciences  Beijing 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