- How It Works
How vNOTES (Scarless Surgery) Works
vNOTES (vaginal Natural Orifice Transluminal Endoscopic Surgery) is a minimally invasive “scarless” approach that uses the vagina as the access route for laparoscopic cameras and instruments. It’s typically offered for benign gynaecologic procedures (e.g., hysterectomy, salpingectomy/oophorectomy, selected adnexal surgery) after a personalised assessment of symptoms, ultrasound findings, medical history, and goals. Compared with conventional laparoscopy, studies—including an RCT (HALON) and recent reviews—show vNOTES achieves similar surgical success with the potential for shorter operative time, less blood loss, and earlier discharge, while maintaining the recovery advantages of minimally invasive routes over open surgery.
On the day of surgery, you’ll have anaesthesia. The surgeon makes a small incision inside the vagina (a posterior colpotomy) and places a soft single-port device to gently create working space in the abdomen. A tiny camera and slim instruments are introduced without any abdominal cuts. The procedure is performed endoscopically—removing the uterus and/or treating the ovaries/tubes as planned—then the internal vaginal incision is closed. Many patients go home the same day because the approach avoids abdominal wounds and typically requires less pain medicine.
Afterwards, mild cramping and a light, blood-stained or watery discharge are common for a short period. We’ll give you written aftercare, but general guidance includes pelvic rest—no tampons, swimming, or vaginal intercourse—until the incision has healed (often about 4–6 weeks, or as advised at review). We’ll also discuss a gradual return to activity and the warning signs that should prompt a call. Most patients resume normal routines quickly compared with abdominal surgery.
