Evaluation of Single-Port vNOTES (Vaginal Natural Orifice Translumenal Endoscopic Surgery) versus Conventional Laparoscopy for Benign Adnexal Masses

International Journal of Obstetrics and Gynecology | Vol. 14, No. 6, June 2026 | pp. 37–48

DOI: 10.46882/2026/IJOG/000480

Original Research Article

Title: Evaluation of Single-Port vNOTES (Vaginal Natural Orifice Translumenal Endoscopic Surgery) versus Conventional Laparoscopy for Benign Adnexal Masses

Names of Authors: Olayinka O. Cole¹, Nesta C. Chuka¹

Authors’ Affiliations:
¹ Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria

Abstract:
Vaginal Natural Orifice Translumenal Endoscopic Surgery (vNOTES) represents an innovative paradigm shifting the execution of minimally invasive gynecologic procedures by eliminating visible abdominal incisions. This prospective randomized controlled trial compared the perioperative outcomes, postoperative pain scores, and cosmetic satisfaction of single-port vNOTES versus conventional multi-port laparoscopy for the surgical excision of benign adnexal masses. A total of 140 women requiring surgical intervention for benign ovarian cysts or adnexal pathologies (mass diameter ≤ 8 cm) were randomized to either the vNOTES group (n = 70) or the conventional laparoscopy group (n = 70). The primary endpoints evaluated included total operative time, visual analog scale (VAS) pain scores at 12 and 24 hours postoperatively, and analgesic consumption. The mean operative time was significantly shorter in the vNOTES group compared to the laparoscopy group (42.5 ± 11.2 minutes vs. 56.8 ± 14.5 minutes, p < 0.001). Postoperative VAS pain scores were significantly lower in the vNOTES cohort at both 12 hours (2.1 ± 0.6 vs. 4.4 ± 1.1, p < 0.001) and 24 hours (1.2 ± 0.4 vs. 2.8 ± 0.8, p < 0.001), resulting in a 45.0% reduction in total postoperative opioid consumption. The median length of hospital stay was shorter for vNOTES patients (14.2 hours vs. 26.5 hours, p = 0.004). Cosmetic satisfaction scores evaluated at week 6 were significantly higher in the vNOTES group due to the complete absence of abdominal scars (9.8 ± 0.4 vs. 7.6 ± 1.2, p < 0.001). Complication rates, including pelvic infection and hematoma, did not differ significantly between the arms (p > 0.05). Single-port vNOTES for benign adnexal masses is a safe, efficient, and highly reproducible surgical technique that minimizes operative duration, reduces postoperative pain, and eliminates abdominal scarring compared to conventional laparoscopy.

Keywords: vNOTES; Laparoscopy; Adnexal Mass; Ovarian Cystectomy; Postoperative Pain; Minimally Invasive Surgery.

Manuscript Timeline: Received: February 12, 2026; Revised: April 05, 2026; Accepted: May 02, 2026; Published: June 08, 2026.

Citation: Cole OO, Chuka NC. Evaluation of Single-Port vNOTES (Vaginal Natural Orifice Translumenal Endoscopic Surgery) versus Conventional Laparoscopy for Benign Adnexal Masses. International Journal of Obstetrics and Gynecology. 2026; 14(6): 37–48.

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