Robotic natural orifice transluminal endoscopic surgery (R-NOTES) in gynecologic surgeries, a case report and review of literature

Abstract

Background: Natural Orifice Transluminal Endoscopic Surgery (NOTES) involves accessing the abdominal cavity through a natural orifice. It provides easier access for the surgeon; has a reduced recovery times and decreases postoperative pain Objective: To present an initial experience with robotic natural orifice transluminal surgery (R-NOTES) in gynecology using the da Vinci surgical system. Case: We present a case of a 40 year old, Asian female, Gravida 2- Para 1-0-1-1 with irregular, heavy menstrual cycle, abnormal uterine bleeding due to uterine leiomyoma (AUB-L) who under went Da Vinci Natural Orifice Transluminal Endoscopic Surgery (NOTES), total Laparoscopic hysterectomy (TLH), bilateral salpingectomy (BS), Lysis of adhesions (LOA), and cystoscopy. The patient had uncomplicated recovery and postoperative care and was discharged on postoperative day zero. Conclusion: Robotic NOTES Total laparoscopic hysterectomy with bilateral salpingectomy is feasible and safe in gynecology patient. This approach has the potential for a less morbid and scarless outcome.