{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:04:10Z","timestamp":1774325050988,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare outcomes, efficacy, and safety of vNOTES versus conventional laparoscopy and laparoendoscopic single\u2010site surgery salpingectomy for ectopic pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic databases including PubMed, Medline, Cochrane Library, and Embase were systematically searched. Articles were evaluated according to specified inclusion criteria. Data were extracted and reviewed, with reported duration of procedure and length of patient stay as primary outcomes. Due to heterogeneity of data, analysis was further stratified depending on whether the control groups underwent conventional laparoscopy or laparoendoscopic single\u2010site surgery. Secondary outcomes include success rates, estimated blood loss, Visual Analogue Scores (VAS) for postoperative pain and complications. A formal risk of bias assessment accompanied the included studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010one studies were included within the review with a cumulative total of 405 cases of vNOTES salpingectomy. Studies included randomized control trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), cohort control studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), case series (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912), and case report (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Meta\u2010analyses of duration of procedure and length of stay were performed across seven papers (stratified according to control groups). This revealed a significant reduction in length of stay but similar duration of surgery under fixed and random effects models (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) for vNOTES versus conventional laparoscopic salpingectomy. Patients undergoing vNOTES salpingectomy versus laparoendoscopic single\u2010site surgery had similar duration of surgery and length of stay. Women who had vNOTES demonstrated lower VAS pain scores and reduced analgesia requirements. Up to 4% of cases may need conversion to laparoscopy (these were cases associated with pelvic adhesions or torrential hemorrhage), and documented complications included hemorrhage, post\u2010operative pyrexia, and need for blood transfusion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>vNOTES salpingectomy for ectopic pregnancy appears to be a safe and feasible procedure, with high levels of patient satisfaction and low pain scores. The heterogeneity of data of the control groups is acknowledged and patients undergoing vNOTES versus conventional laparoscopic salpingectomy had reductions in length of stay but similar duration of surgery, while vNOTES salpingectomy versus laparoendoscopic single\u2010site surgery incurred similar duration of surgery and length of stay. Procedural standardization and larger randomized clinical trials to assess long\u2010term outcomes are crucial if vNOTES salpingectomy should become widely used for surgical treatment of ectopic pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70250","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T02:53:20Z","timestamp":1773802400000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Systematic Review of Vaginal Natural Orifice Transluminal Endoscopic Surgery (\n                    <scp>vNOTES<\/scp>\n                    ) versus Laparoscopic Salpingectomy in the Management of Ectopic Pregnancy"],"prefix":"10.1111","volume":"52","author":[{"given":"Kirsty","family":"Hartshorn","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology North Middlesex University Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Wylie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology North Middlesex University Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Department of Urology Salisbury District Hospital  Salisbury UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helienke","family":"Yoong","sequence":"additional","affiliation":[{"name":"Barts and the London School of Medicine and Dentistry  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai","family":"Yoong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology North Middlesex University Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0291316"},{"key":"e_1_2_12_3_1","unstructured":"Royal College of Obstetrics and Gynaecology. 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