Comparison of transvaginal natural orifice transluminal endoscopic surgery and laparoendoscopic single-site surgery for tubal pregnancy

Transvaginal natural orifice transluminal endoscopic surgery (v-NOTES) offers several unique advantages including reduced postoperative pain and improved cosmetic outcomes. This study aimed to evaluate the effectiveness of v-NOTES in the treatment of tubal pregnancy, with a focus on patient outcomes and cost-effectiveness. A retrospective analysis was conducted on 40 cases of tubal pregnancy treated surgically between December 1, 2020 and May 31, 2022. Patients were divided into 2 groups: the v-NOTES group (n = 20), who underwent transvaginal natural orifice transluminal endoscopic surgery, and the control group (n = 20), who underwent laparoscopic single-site surgery (LESS). Key variables including age, body mass index, operative time, intraoperative blood loss, postoperative pain, recovery time, and total costs were evaluated and compared between the 2 groups. Operative time and intraoperative blood loss were comparable between the 2 groups, patients in the v-NOTES group reported significantly lower postoperative pain scores and shorter hospital stays (P < .05). Additionally, the time return to normal activity was markedly shorter in the v-NOTES group compared to the LESS group (16 hours vs 25 hours, respectively). Both procedures demonstrated similar safety profiles; but v-NOTES was associated with a faster recovery and higher patient satisfaction. V-NOTES is a safe and effective minimally invasive surgical option for tubal pregnancy, providing enhanced recovery and improved patient experience compared to LESS.