Transvaginal Natural Orifice Translumenal Endoscopic Surgery (TVNOTES): Concerns of Gynaecology Outpatients in a Tertiary Care Centre

Renita Lobo, Kannavi Jayashree, Annamma Thomas, Santosh A. Olakkengil

Department of Obstetrics & Gynaecology, St John’s Medical College Hospital, Bangalore, India.
Department of Surgery, St John’s Medical College Hospital, Bangalore, India.

DOI: 10.4236/ojots.2013.32008                

Abstract

Objective: (TVNOTES) [1], currently the most popular of the NOTES procedures being performed, offers the safest access point while avoiding a breach in the gastrointestinal tract to gain intraperitoneal access. But are women ready to embrace TVNOTES? Although similar studies have been conducted in developed nations, the authors aimed to seek the opinions of Indian women towards TVNOTES. Design: This study presents the results of a survey on attitudes of Indian women towards TVNOTES. 300 women attending a gynaecology out patients’ clinic were administered a questionnaire which sought out the percentage of Indian women concerned with surgical scars, their preference between TVNOTES and conventional laparoscopic surgery and apprehensions towards the vagina being used as an entry site for surgery. Results: 85.67% of the participants opted for scarless intra-abdominal surgery. Upon revealing that the surgery would be performed transvaginally (TV), reservations were unveiled, with 67.33% of all respondents being either unhappy or unsure about undergoing TV surgery. Results were initially equivocal when asked to choose between TVNOTES and conventional laparoscopic surgery, but when informed that TVNOTES may be as safe and efficacious as conventional laparoscopic surgery, the scales tipped in favour of TVNOTES, with three-fourths of the respondents opting for the latter. Conclusions: Although TVNOTES has captured the imagination and attention of surgeons, existing data suggest that the beneficiaries (i.e. women) remain to be convinced. This study suggests that Indian women will embrace TV surgery once its safety is proven, improved cosmesis being a predominant factor in making this choice.

Keywords

Giant Hemangioma; Liver Transplant; Case Report

Conflicts of Interest

The authors declare no conflicts of interest.

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