Robot-assisted transvaginal natural orifice transluminal end
The study published in The Journal of Minimally Invasive Gynecology states that robot-assisted transvaginal natural orifice transluminal endoscopic surgery (RvNOTES) is an effective approach in the treatment of endometriosis.

The objective of this study was to describe the surgical techniques and short-term outcomes for 33 cases of robot-assisted transvaginal natural orifice transluminal endoscopic surgery (RvNOTES) to treat endometriosis.

A total of 33 cases of patients, with pathology confirmed endometriosis, who underwent RvNOTES total hysterectomy with resection of endometriosis were included in the study. Thirty-two cases were completed successfully by RvNOTES, and one case was converted to robotic trans-umbilical single incision laparoscopic surgery (SILS) plus one additional port due to an obliterated posterior cul-de-sac and upper abdominal wall endometriosis.

- The average operative time was 141.93±40.22 minutes, and the mean estimated blood loss was 52.25±33.82 milliliters.

- The mean preoperative pain score using the visual analog score (VAS) was 8.08±2.39. The mean VAS pain scores one week after surgery was 6.73±2.62, which was significantly lower when compared to scores preoperatively. The mean VAS pain score in the second and third week after surgery was 4.81±2.42 and 2.63±2.36 respectively, which were both significantly lower than those before surgery.

- There were four postoperative complications: urinary tract infection, pneumonia, headache requiring admission, and conversion disorder.

Conclusively, RvNOTES is a safe and feasible approach for the treatment of endometriosis, with promising short-term improvements in pain.