To investigate the clinical effect of total hysterectomy with bilateral adnexectomy with transvaginal natural orifice transluminal endoscopic surgery (V-NOTES).

20 cases of total hysterectomy with bilateral adnexectomy were completed under V-NOTES in Shenyang Fourth People′s Hospital of department of gynaecology from Jan. 2018 to Jan.2019. All operations are completed under the V-NOTES with the traditional straight rod laparoscopic instruments and 10 mm and 30 degrees of ordinary mirror. The electric coagulation and cutting organizations adopt energy equipment (bipolar, ultrasonic knife). After vaginal excision of the entire uterus, PORT was inserted and bilateral adnexal excision was performed under laparoscope.

The average weight of uterine was (794±115)g, the average operation time was (125±22) min, the intraoperative blood loss was (150+ 58)ml, the average postoperative visual analogue score (VAS) was (2.7±0.7), the average postoperative recovery time of intestinal function was (24±1.92)h, and the average postoperative hospitalized time was (3.85±0.42)d. No complications occurred in the 20 patients, and the average postoperative follow-up time was (45±22)d. There were no obvious self-conscious symptoms in patients following the surgery, with normal urine and bowel moving, normal vaginal discharge, and good healing of vaginal stump incision.

Total hysterectomy with bilateral adnexectomy with V-NOTES is safe and feasible, with no incision in the abdomen. During the operation, the pelvic cavity and abdomen can be simultaneously explored.