{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:12:01Z","timestamp":1778656321613,"version":"3.51.4"},"reference-count":0,"publisher":"Care Comm","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ceska Gynekol"],"published-print":{"date-parts":[[2026,4,22]]},"abstract":"<jats:p>Objective: This study aims to compare the outcomes of laparoscopic hysterectomy (LH) and vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) hysterectomy (vNH) in obese patients undergoing the procedure for benign gynaecological indications, with results classified according to obesity class (class I, II, and III). Materials and methods: We retrospectively reviewed the data of patients with a body mass index (BMI) \u2265 30\u2005kg\/m\u00b2 who underwent either LH or vNH for benign indications at a tertiary teaching and research hospital between January 2020 and December 2024. Results: A total of 134 patients (70 LH, 64 vNH) were included in this single-centre study. The median operative time was significantly longer in the vNH group (205 min vs. 178 min; P &lt; 0.01). Overall, major complication rates were similar between the two groups. The most striking finding of the study was that in patients with class III obesity (BMI \u2265 40\u2005kg\/m\u00b2), the vNOTES approach significantly reduced the conversion rate to laparotomy compared to laparoscopy (0 vs. 23.5%; P = 0.035). Conclusion: Our study demonstrates that the most significant advantage of vNOTES surgery in obese patients undergoing benign hysterectomy is the reduction in the conversion rate to laparotomy, particularly within the class III obesity group. vNOTES statistically eliminated the risk of conversion to laparotomy compared to laparoscopy in patients with class III obesity (OR 0.08; 95% CI 0.00\u20130.91; P = 0.035). These findings underscore the importance of risk stratification based on patient BMI when selecting a minimally invasive surgical approach for obese patients. \n\nKey words: morbid obesity \u2013 natural orifice surgery \u2013 surgical complications \u2013 conversion rate \u2013 patient selection<\/jats:p>","DOI":"10.48095\/cccg2026102","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:35:42Z","timestamp":1778654142000},"page":"102-108","source":"Crossref","is-referenced-by-count":0,"title":["vNOTES hysterectomy reduces laparotomy conversion rates in class III obesity \u2013 a retrospective comparative study"],"prefix":"10.48095","volume":"91","author":[{"given":"Yusuf Ziya","family":"Kizildemir","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Harran University, \u015eanl\u0131urfa, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"\u0130nceb\u0131y\u0131k","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"28151","published-online":{"date-parts":[[2026,4,22]]},"container-title":["\u010cesk\u00e1 gynekologie"],"original-title":["vNOTES hysterectomy reduces laparotomy conversion rates in class III obesity \u2013 a retrospective comparative study"],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:35:44Z","timestamp":1778654144000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cs-gynekologie.cz\/en\/journals\/czech-gynaecology\/2026-2-8\/vnotes-hysterectomy-reduces-laparotomy-conversion-rates-in-class-iii-obesity-a-retrospective-comparative-study-143550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,22]]},"published-print":{"date-parts":[[2026,4,22]]}},"URL":"https:\/\/doi.org\/10.48095\/cccg2026102","relation":{},"ISSN":["1210-7832","1805-4455"],"issn-type":[{"value":"1210-7832","type":"print"},{"value":"1805-4455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]}}}