V-Notes: Benefits in Benign Gynecological Surgery

V-Notes surgery is a laparoscopy performed via the vaginal route. It combines the benefits of the vaginal route, which avoids visible scars, with the advantages of laparoscopic vision. In common practice, V-Notes is used for performing hysterectomies and certain adnexal procedures (adnexectomy and permanent contraception). Other procedures can be performed via V-Notes, but currently, there is insufficient evidence. For hysterectomy, contraindications to V-Notes include the presence of endometriosis and oncological indications based on current knowledge.
The V-Notes approach has shown a reduction in postoperative pain and operative time, with an increase in the number of hysterectomies that can be performed on an outpatient basis when compared to laparoscopy. This innovation could facilitate and promote the return of the vaginal route for the benefit of women's health.