Evaluation of Single-Port vNOTES versus Conventional Laparoscopy for Myomectomy in Subserosal Leiomyomas

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 843–854

DOI: 10.46882/2026/IJOG/000551

Original Research Article

Title: Evaluation of Single-Port vNOTES versus Conventional Laparoscopy for Myomectomy in Subserosal Leiomyomas

Names of Authors: Olayinka O. Cole¹, Nesta C. Chuka¹

Authors’ Affiliations:
¹ Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria

Abstract:
Vaginal Natural Orifice Translumenal Endoscopic Surgery (vNOTES) eliminates visible abdominal scar formation by using the vaginal pathway for endoscopic execution. This prospective randomized controlled trial compared the surgical parameters, postoperative pain intensity, and cosmetic satisfaction scores of single-port vNOTES myomectomy against conventional multi-port Laparoscopy (CL) for the excision of subserosal uterine leiomyomas. One hundred premenopausal women requiring surgical myomectomy for symptomatic subserosal fibroids (maximum diameter ≤ 8 cm) were randomized to either the vNOTES group (n = 50) or the CL group (n = 50). The primary endpoints evaluated included total operative duration, visual analog scale (VAS) pain scores at 12 and 24 hours post-surgery, and total analgesic consumption. The mean operative time was significantly shorter in the vNOTES cohort compared to the CL cohort (45.5 ± 12.2 minutes vs. 64.8 ± 15.4 minutes, p < 0.001). Postoperative VAS pain scores were lower in the vNOTES cohort at both 12 hours (1.8 ± 0.4 vs. 3.8 ± 1.1, p < 0.001) and 24 hours (1.1 ± 0.3 vs. 2.4 ± 0.6, p < 0.001), yielding a 40.0% reduction in postoperative ward opioid requirements. Cosmetic outcome scores evaluated 6 weeks post-surgery were significantly higher in the single-incision vaginal arm due to the absolute absence of abdominal scars (9.8 ± 0.2 vs. 7.4 ± 0.9, p < 0.001). Single-port vNOTES myomectomy for benign subserosal fibroids is a safe approach that minimizes operative durations, limits early postoperative pain, and avoids visible abdominal scarring compared to conventional multi-port laparoscopy.

Keywords: vNOTES; Myomectomy; Subserosal Fibroids; Laparoscopy; Postoperative Pain; Cosmetic Satisfaction.

Manuscript Timeline: Received: July 25, 2026; Revised: August 28, 2026; Accepted: September 06, 2026; Published: September 12, 2026.

Citation: Cole OO, Chuka NC. Evaluation of Single-Port vNOTES versus Conventional Laparoscopy for Myomectomy in Subserosal Leiomyomas. International Journal of Obstetrics and Gynecology. 2026; 14(9): 843–854.

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