Clinical Efficacy of Single-Port vNOTES versus Multi-Port Conventional Laparoscopy for Benign Ovarian Cystectomy

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 987–998

DOI: 10.46882/2026/IJOG/000563

Original Research Article

Title: Clinical Efficacy of Single-Port vNOTES versus Multi-Port Conventional Laparoscopy for Benign Ovarian Cystectomy

Names of Authors: Charlotte de Jong¹, Emily R. Watson²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Amsterdam, Netherlands
² Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Australia

Abstract:
Vaginal Natural Orifice Translumenal Endoscopic Surgery (vNOTES) provides an alternative minimally invasive pathway that avoids visible abdominal skin incisions. This prospective randomized controlled trial compared the perioperative surgical outcomes, early postoperative pain patterns, and cosmetic satisfaction profiles of single-port vNOTES cystectomy against multi-port Conventional Laparoscopy (CL) for benign adnexal masses. One hundred and twenty women presenting with unilateral benign ovarian cysts (maximum diameter ≤ 8 cm) requiring surgical removal were randomized to either the vNOTES cohort (n = 60) or the CL cohort (n = 60). The primary outcomes were total operative duration and visual analog scale (VAS) pain scores at 12 and 24 hours postoperatively. The mean operative duration was significantly shorter in the vNOTES group compared to the CL group (38.4 ± 9.2 minutes vs. 52.6 ± 12.4 minutes, p < 0.001). Postoperative VAS pain scores were lower in the vNOTES group at 12 hours (1.8 ± 0.5 vs. 3.6 ± 1.1, p < 0.001) and 24 hours (1.1 ± 0.3 vs. 2.2 ± 0.5, p < 0.001), resulting in a 35.0% reduction in total postoperative ward analgesic consumption. Cosmetic satisfaction scores recorded at week 6 were significantly higher in the single-incision vaginal arm (9.8 ± 0.2 vs. 7.6 ± 1.1, p < 0.001). Single-port vNOTES for benign ovarian cystectomy is an efficient intervention that shortens operational intervals, limits early postoperative pain, and eliminates abdominal scarring compared to conventional multi-port laparoscopy.

Keywords: vNOTES; Laparoscopy; Ovarian Cystectomy; Postoperative Pain; Cosmetic Outcome; Minimally Invasive Surgery.

Manuscript Timeline: Received: June 28, 2026; Revised: August 22, 2026; Accepted: September 10, 2026; Published: September 18, 2026.

Citation: de Jong C, Watson ER. Clinical Efficacy of Single-Port vNOTES versus Multi-Port Conventional Laparoscopy for Benign Ovarian Cystectomy. International Journal of Obstetrics and Gynecology. 2026; 14(9): 987–998.

Subscribe to read the full article: https://mail.internationalscholarsjournals.org/subscribe-to-read