Abstract
To evaluate the clinical efficacy and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for treating benign ovarian tumors in obese patients. A retrospective analysis was conducted on the clinical data of 35 obese patients who underwent vNOTES for benign ovarian tumor resection and 41 obese patients who underwent multi-port laparoscopic surgery (MPLS) during the same period from January 2021 to June 2024 at Qinghai Red Cross Hospital. Key parameters such as operative time, intraoperative blood loss, intraoperative and postoperative complications, hospitalization duration, postoperative anal exhaust time, postoperative visual analog scale (VAS) score, and SF-36 score were analyzed. No statistical differences were observed between the two groups regarding baseline characteristics such as age, body mass index (BMI), tumor diameter, parity, and history of pelvic surgery. The vNOTES group exhibited shorter operative times compared to the MPLS group, with no significant differences in tumor pathology, intraoperative blood loss, or tumor rupture rates. Postoperatively, the vNOTES group had shorter hospital stays, fewer postoperative complications, lower 24-hour postoperative VAS scores, and higher three-month postoperative SF-36 scores compared to the MPLS group. No differences were found between the groups concerning anal exhaust time, sexual satisfaction rate, or 24-hour postoperative VAS scores. vNOTES is a safe and feasible surgical method for treating benign ovarian tumors in obese patients, offering advantages such as no abdominal incisions and quicker postoperative recovery.