Clinical Report: Comparative Analysis of Uterine-Sparing vNOTES and LLS

Overview

This study compares the feasibility and outcomes of vNOTES and laparoscopic lateral suspension (LLS) for pelvic organ prolapse repair. Findings indicate that vNOTES offers shorter operative times and improved functional outcomes without compromising safety.

Background

Pelvic organ prolapse (POP) is a prevalent condition affecting women's quality of life, particularly in older populations. Surgical intervention remains the most effective treatment for advanced cases. The emergence of minimally invasive techniques like vNOTES and LLS provides alternatives that may enhance recovery and outcomes for patients.

Data Highlights

Key Findings

• Both vNOTES and LLS achieved successful anterior-apical correction.
• Operative time was significantly shorter for vNOTES compared to LLS (60.4 vs. 90.7 min).
• Length of hospital stay was reduced with vNOTES (1.32 vs. 1.98 days).
• Functional outcomes favored vNOTES with lower POPDI-6 and UDI-6 scores at follow-ups.
• No mesh exposures were reported in either group.
• Complication rates were low and comparable between both techniques.

Clinical Implications

The findings suggest that vNOTES may be a preferable option for patients requiring pelvic organ prolapse repair due to its shorter recovery time and improved functional outcomes. Clinicians should consider these advantages when discussing surgical options with patients.

Conclusion

Both vNOTES and LLS are effective for uterus-preserving prolapse repair, with vNOTES demonstrating superior perioperative recovery and functional improvement. Further long-term studies are needed to assess durability of outcomes.

Related Resources & Content

1. Techniques in Coloproctology, 2025 -- A Retrospective Clinical Analysis of Laparoscopic Lateral Suspension Versus High Uterosacral Ligament Suspension for Treating Apical Prolapse
2. Surgical Endoscopy, 2024 -- Expert Consensus on the Use of Lateral Suspension Techniques for Managing Pelvic Organ Prolapse: Findings from a Delphi Survey
3. Impact of Transvaginal Hybrid-NOTES Techniques on Pregnancy Outcomes and Delivery Processes, 2021
4. Pelvic Organ Prolapse (POP): Surgical Mesh Considerations and Recommendations | FDA
5. Hernia — Early Insights into Transvaginal Repair of Incisional Hernias
6. Pelvic Organ Prolapse (POP): Surgical Mesh Considerations and Recommendations | FDA
7. A Randomized Clinical Trial Comparing Dubuisson Laparoscopic Lateral Suspension with Laparoscopic Sacropexy for Pelvic Organ Prolapse: Short-Term Results
8. Two-Year Follow-Up on Surgical Outcomes of vNOTES High Uterosacral Ligament Suspension for the Prophylaxis and Treatment of Pelvic Organ Prolapse: A Multicenter Prospective Cohort Study - ScienceDirect