vNOTES Uterosacral Hysteropexy

INTRODUCTION: Patients are increasingly opting for uterine-sparing prolapse repairs, benefiting from decreased blood loss and shorter operating times. However, accessing suspensory ligaments with the uterus in situ is challenging, and many providers opt to perform this procedure laparoscopically. Vaginal natural orifice transluminal endoscopic (vNOTES) approach offers a minimally invasive vaginal approach that utilizes laparoscopic technique, giving the surgeon improved visualization of the pelvic anatomy. OBJECTIVE: The purpose of this video abstract is to demonstrate step-by-step instruction with techniques for performing a vaginal natural orifice transluminal endoscopic uterosacral hysteropexy. Additionally, the video shows the advantages and key considerations with performing uterosacral hysteropexy using the vNOTES technique. METHODS: Prior to recording, informed consent for obtaining images and video of the procedure was obtained. The video clips were selected and edited to create a cohesive and informative educational video, including English captions and narration. Measures were taken to protect the patient's privacy and confidentiality throughout the video creation process. The target audiences for this education video are gynecologic surgeons, fellows, and residents. RESULTS: The surgeon demonstrates the steps of performing a uterosacral hysteropexy using the assistance of vNOTES to complete the procedure vaginally. CONCLUSIONS: In conclusion, vaginal natural orifice transluminal endoscopic surgery offers improved visualization to safely and effectively perform uterosacral hysteropexies vaginally.