To evaluate and compare the feasibility and safety via transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and laparoscopy for ovarian cysts.

The present retrospective cases series included consecutive patients who underwent ovarian cysts surgery through vNOTES and laparoscopy access at West China Second Hospital of Sichuan University, between Nov. 2017 and Apr. 2018. There were 18 women, each group contain 9 patients. A statistical analysis for the data of patients and surgery situation was did.

All the 18 surgeries were successfully performed, without convention, there were no noticeable complications during or after operation.For the part of surgery history, the vNOTES group showed less number compared with laparoscopic group(P<0.05). Compared the groups between vNOTES and laparoscopy surgery in terms of the mean operation time was 115 min vs 108.89 min, the mean drop of hemoglobin level was 16.22 g/L vs 16.33 g/L, the mean length of hospitalization was 2.78 d vs 3.33 d, the mean visual analogue scale (VAS) score was 1.89 vs 2.78 at 12 h after operation, the mean time for cosmetic scale (CS) score was 22.67 vs 17.78 for 1 week after surgery, and 23.44 vs 18.56 after 4 weeks, all of them did not show significant differences among the groups. But the vNOTES group showed higher CS score at 4 weeks(23.44 vs 18.56)and 24 weeks(23.89 vs 19.11)compared to the laparoscope (P<0.05).

Since vNOTES showed high patient satisfaction with the scarless result, after fully evaluated and selected, the vNOTES access approaches were feasible and safe compared to laparoscopic surgery for ovarian cystectomy.