v-NOTES Bilateral Salpingectomy Under Spinal Anesthesia: A Pilot Study

Objective: The aim of this pilot study is to evaluate the feasibility and clinical outcomes of bilateral salpingectomy performed using the vaginal natural orifice transluminal endoscopic surgery (vNOTES) technique under spinal anesthesia in women requesting permanent contraception. Methods: In this study, bilateral salpingectomy was performed using the vNOTES technique under spinal anesthesia in 12 multiparous patients who requested permanent contraception. Demographic characteristics, surgery duration, intraoperative vital signs, preoperative and postoperative hemoglobin and hematocrit values, pain scores using the visual analog scale (VAS), and postoperative complications were recorded. The Quality of Recovery-15 (QoR-15) recovery questionnaire was administered prior to discharge. Results: The mean age of the patients was 36.66 ± 5.67 years, and the mean body mass index was 27.33 ± 6.97 kg/m 2 . The mean surgery duration was 25.66 ± 14.55 minutes, and the mean hospital stay was 22.45 ± 3.30 hours. The mean VAS score was 3.83 ± 1.74 at 6 hours postoperatively and 2.23 ± 1.15 at 12 hours postoperatively. Shoulder pain was observed in three patients. No major intraoperative or postoperative complications were observed in any patient. The mean total score on the QoR-15 Recovery Questionnaire was 107.83 ± 15.74. Conclusion: Bilateral salpingectomy performed with vNOTES under spinal anesthesia appears to be a safe and feasible minimally invasive surgical method in women seeking permanent contraception, offering a short surgical duration, low postoperative pain scores, and a short hospital stay. Prospective studies with larger patient series are needed to validate these findings.