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ORIGINAL RESEARCH article
Front. Surg.
Sec. Obstetrics and Gynecological Surgery
Volume 12 - 2025 |
doi: 10.3389/fsurg.2025.1542486
Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Early-Stage Ovarian Cancer and Borderline Ovarian Tumors: A Case Series
Provisionally accepted- 1 University of Geneva, Geneva, Geneva, Switzerland
- 2 Hôpitaux universitaires de Genève (HUG), Genève, Geneva, Switzerland
- 3 Valais Romand Hospital Center, Sion, Valais, Switzerland
- 4 CHVR, Sion, Switzerland
Introduction: Surgery is the cornerstone of ovarian cancer treatment. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is a novel, minimally invasive technique that is gaining interest in gynecological oncology. However, its use in ovarian cancer is still limited, with only a few cases reported. This study aimed to evaluate the feasibility of vNOTES for the surgical staging of borderline and early-stage ovarian cancer. Methods: We retrospectively reviewed all cases of borderline ovarian tumors (BOTs) and early-stage ovarian cancer surgically staged by vNOTES at our institution between October 2021 and August 2024. Results: Eleven patients were included, seven with early-stage ovarian or tubal cancer and 4 with BOTs. The median age was 47 (27 -81) years, and the median body mass index was 28.1 (22.4 -39.2) Kg/m². Complete vNOTES staging was achieved in all cases, including peritoneal washing, unilateral/bilateral salpingo-oophorectomy, abdominal cavity inspection, peritoneal biopsies, infracolic omentectomy, and total hysterectomy when required. The median operating time was Mis en forme : Justifié 70 (35 -138) minutes, with a median blood loss of 50 (10 -100) ml. No intraoperative complications occurred except for one case of minor ovarian spillage. No conversions to conventional laparoscopy or laparotomy were needed. Postoperative complications included one surgical site infection (9.1%) and 2 cases of postoperative cystitis (18.2%). No severe complications graded ≥3 on the Clavien-Dindo classification were observed. Conclusion:vNOTES appears to be a feasible approach for the surgical staging of highly selected patients with early-stage adnexal malignancies. Further studies are needed to validate its long-term safety and oncological outcomes. Mis en forme : Anglais (États-Unis) Mis en forme : Anglais (États-Unis) Mis en forme : Police :12 pt Tableau mis en forme
Keywords: Early-stage ovarian cancer, Non-epithelial ovarian cancer, Borderline ovarian cancer, natural orifice transluminal endoscopic surgery, vNOTES, minimally invasive surgery, Fertility-sparing surgery, Ovarian cancer treatment
Received: 09 Dec 2024; Accepted: 07 Feb 2025.
Copyright: © 2025 Kellerhals, Nef, Hurni and Huber. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Daniela Huber, CHVR, Sion, Switzerland
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