Postoperative Outcomes of V-notes (Transvaginal Natural Orifice Transluminal Endoscopic Surgery) Sacrocolpopexy in Patients with Pelvic Organ Prolapse

Abstract

Background: This study introduces and evaluates a novel surgical approach for treating pelvic organ prolapse (POP) by combining vaginal natural orifice transluminal endoscopic surgery (V-NOTES) with sacrocolpopexy. The aim was to provide maximal benefit to patients through this approach, eliminating the need for additional incisions and utilizing the anterior longitudinal ligament for suspension. Materials and Methods: The study enrolled 11 patients who underwent V-NOTES sacrocolpopexy after vaginal hysterectomy. The patients’ quality of life improved significantly after the procedure, as indicated by the pelvic floor impact questionnaire and pelvic floor distress inventory scores. The technique involved using helical titanium tacks to secure the mesh to the anterior longitudinal ligament, streamlining the procedure and standardizing mesh fixation. Results: The median age of patients was 64 years. The median operative time for V-NOTES sacrocolpopexy was 150 minutes. There were no perioperative complications, and postoperative pain scores were minimal. Patients expressed high satisfaction with cosmetic outcomes, and physical examination findings demonstrated significant improvement in POP. Conclusion: V-NOTES sacrocolpopexy is an effective and promising approach for managing POP prolapse after vaginal hysterectomy. The procedure demonstrated positive outcomes in terms of operative time, complications, pain scores, cosmetic results, and hospital stay. Moreover, it significantly improved patients’ quality of life, positively impacting daily activities and emotional well-being. As the incidence of POP is expected to rise with an aging population, V-NOTES sacrocolpopexy may offer a minimally invasive alternative for treating apical compartment prolapse.