vNOTES chromopertubation: a new method for assessing tubal patency and peritubal anatomy.

Abstract

Background: We conducted a retrospective cohort study of women with suspected tubal factor infertility who underwent vaginal natural orifice endoluminal surgery (vNOTES) chromopertubation and adnexal anatomy assessment at a large referral hospital.

Methods: Twelve women aged between 29 and 38 years with suspected tubal factor infertility who underwent vNOTES chromopertubation were retrospectively examined. Demographic data, as well as clinical and surgical characteristics, were reviewed and the surgical technique was defined.

Results: The mean BMI was 34.2 ± 7.12 kg/m² (range 24.7-42.6). No conversion to laparotomy or laparoscopy was required. The median operative time was 39 (26.5-42) minutes. The median VAS scores at six and 12 h postoperatively were 3.5 (3-4) and 2 (1-2), respectively. There were no complications and all patients were discharged at the 12th postoperative hour.

Conclusions: Considering the increased risk of surgical morbidity and mortality associated with increasing BMI and the difficulty in gaining access to the abdominal cavity not only in obese women but also in cases with previous extensive midline incisions, where dense intra-abdominal adhesions are likely, or in cases where esthetic considerations are important, vNOTES appears to be a useful alternative to assess tubal patency and adnexal anatomy and even to perform concomitant adnexal surgery.