To evaluate the safety, feasibility and advantages of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in the treatment of giant ovarian benign tumors.

The clinical data of patients who underwent surgery for giant benign ovarian tumors (diameter≥10 cm) in the Affiliated Hospital of Guizhou Medical University and Guizhou Provincial People′s Hospital from May 2020 to Jun. 2022 were retrospectively analyzed. According to different surgery methods, the patients were divided into vNOTES (16 cases), laparoscopic single-site surgery (LESS, 54 cases) and traditional multiport laparoscopic surgery (MLS, 38 cases). The operative time, cyst fluid leakage rate, intraoperative blood loss, postoperative exhaust time, 24 h postoperative pain visual analogue score, hospital stay, hospitalization cost, postoperative incision cosmetic score and short-term postoperative complication were compared and analyzed among the three groups.

Compared with the LESS group and the MLS group, the vNOTES group had statistically significant differences in the cystic fluid leakage rate, postoperative exhaust time and pain score at 24 hours after operation (P< 0.05). There were no significant differences in the mass diameter size, intraoperative blood loss, operation time, total hospitalization cost, postoperative complications, postoperative inflammatory indicators, and ovarian tumor markers among the three groups (P> 0.05).

vNOTES surgery is safe and effective in the giant benign ovarian tumors. Compared with LESS and MLS groups, vNOTES surgery has the advantages of minimally invasive, lower cyst fluid leakage rate, shorter postoperative recovery time, and no scar on the body surface.