When surgery is necessary, many women seek an option that is both effective and as gentle as possible.

vNOTES is a minimally invasive surgical technique that can reduce postoperative pain, support a faster recovery, and leave no visible scars on the abdomen. In this interview, Professor Dr. Ingolf Juhasz-Böss and Dr. Lisa Jung answer some of the most frequently asked questions about this innovative approach.

How does vNOTES differ from regular surgery?

vNOTES (Vaginal Natural Orifice Transluminal Endoscopic Surgery) is a minimally invasive surgical procedure that allows the surgeon to access the abdominal cavity through the vagina.

Unlike conventional laparoscopy or open surgery, vNOTES does not require skin incisions on the abdomen. For many patients, this means less postoperative pain, a shorter hospital stay, quicker recovery, and no visible abdominal scars.

Which patients may benefit from vNOTES, and when might another surgical option be better?

vNOTES may be suitable for women who need gynecological procedures such as the removal of ovarian cysts, treatment of selected cases of endometriosis, hysterectomy, or removal of the ovaries. The technique can be particularly beneficial when a minimally invasive approach is preferred. 

Other surgical approaches may be more appropriate in cases of very large tumors, extensive previous surgery, genital cancer, or anatomical factors that make vaginal access difficult.

Are there any risks patients should know about?

As with any surgical procedure, there are general risks such as bleeding, infection, injury to nearby organs, or complications related to anesthesia.

According to current studies, these risks are comparable to those of other minimally invasive surgical techniques.

What benefits do patients usually notice most?

Patients often report less postoperative pain, a quicker return to everyday life, and a reduced need for pain medication. The absence of visible scars and a shorter hospital stay are also seen as significant advantages.

What does vNOTES mean for future pregnancy and endometriosis treatment?

When carefully indicated, vNOTES can be used as a fertility-preserving surgical option and, based on current knowledge, does not appear to have a negative effect on future pregnancy.

In the treatment of endometriosis, vNOTES allows precise visualization and removal of endometriosis lesions. However, for deep-infiltrating endometriosis, conventional laparoscopy or robotic surgery is currently the standard treatment approach.

• Department of Gynecology and Obstetrics