To investigate the feasibility and safety of transvaginal natural endoscopic surgery (NOTES) for endometrial carcinoma.

From Aug. 2017 to Jul. 2018, patients with endometrial carcinoma were prospectively enrolled in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Third Military Medical University. Demographic characteristics, perioperative parameters and clinical outcome were statistically analyzed.

All 5 patients were successfully operated. Vaginal hysterectomy was performed in 2 patients, NOTES hysterectomy was performed in 3 patients, and all 5 cases of bilateral salpingo-oophorectomy were performed under NOTES. Pelvic lymphadenectomy was performed in 3 patients, sentinel lymph node biopsy was performed in 1 patient, and pelvic lymphadenectomy plus para-aortic lymphadenectomy was performed in 1 patient. The median operative time was 195 minutes (130-235 minutes), the median blood loss was 100 ml (50-200 ml), and the median postoperative hospital stay was 5 days (4-9 days). The median postoperative recovery time was 17 hours (12-32 hours), the median postoperative 12 hours pain score was 1 (1-2) and the median postoperative 24 hours pain score was 1 (1-1). The median follow-up time were 4 months, the vaginal stump incision healed well in all patients.

NOTES is a safe and effective method for surgical staging of endometrial carcinoma, but further clinical studies are needed to evaluate its complete clinical application.