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vNotes hysterectomy is a minimally invasive surgery that removes your uterus through a single, small incision in your vagina. This type of laparoscopic surgery uses a special device, video monitors and instruments to reach your uterus without the need for any incisions in your abdomen.
The name vNotes stands for vaginal natural orifice transluminal endoscopic surgery. Along with removing the uterus to treat conditions like uterine fibroids, it may be used to perform other gynecologic surgeries, such as “tying” your tubes, fallopian tube removal, draining ovarian cysts or pelvic organ prolapse repair.
You might choose vNotes hysterectomy to relieve symptoms of fibroids, pelvic pain, abnormal bleeding, uterine prolapse or other uterine conditions. Even if you have factors like a large uterus, previous C-sections or have never had a vaginal delivery, the vNotes approach may still be an option for you.
In some cases, vNotes is not a good fit. You may not be able to have this type of hysterectomy if you have:
The vNotes approach to hysterectomy lets your care team visualize and reach your pelvic organs, including your uterus, with improved access—all through a small, non-visible incision. Because of this, it offers several benefits compared to traditional or laparoscopic surgery through the abdomen or other vaginal hysterectomy approaches.
Benefits of vNotes include:
Like any surgery, you’ll want to talk with your doctor about the pros and cons of vNotes hysterectomy and if it’s right for you. Before your surgery, your doctor will explain the procedure and order pre-surgical tests. You’ll also receive instructions on stopping medications and fasting before surgery.
The vNotes procedure is performed by an obstetrics and gynecology physician with special training in using the vNotes device during surgery. This device allows your doctor to perform your hysterectomy through a small incision in the vagina while providing similar access to your uterus and other pelvic organs as a surgery performed through an abdominal incision.
Because of this specialized, minimally invasive approach, many people are able to go home on the same day as surgery. Your care team will give you an estimate of when you should expect to leave the hospital.
Your doctor may ask you to avoid certain medications or stop eating and drinking at a certain time before surgery. Be sure to follow the specific steps given to you. Once at the hospital, your nursing team will help you get ready for surgery, including changing into a gown and starting an intravenous drip (IV).
You can expect to have general anesthesia so that you are not awake during your procedure. In the pre-op area, you’ll have a chance to talk with your doctor and anesthesia provider before your procedure begins.
Once you are asleep, your doctor will make an incision (less than an inch wide) in the inside of your vagina near the cervix. Then, the vNotes device will be inserted through this incision to reach your uterus. Your doctor will also insert a lighted camera and other tools through the device.
To help your doctor have better access to your uterus and other organs, your care team will pump air into your abdomen to inflate it. Then, your doctor will remove your uterus through the small incision using the device. After the surgery is complete, the device is removed, and the gas is released from your abdomen. In most cases, the total procedure takes one to two hours.
After your vNotes hysterectomy, you’ll spend a short time in the post-anesthesia care unit, and your doctor will let you know if you are able to go home the same day. Because you’ll have general anesthesia, you’ll need to plan for someone to drive you home.
The small incision used in the vNotes procedure typically means less pain after surgery. Your doctor may give you prescription medications for the pain, or you may be able to manage any discomfort with over-the-counter pain relievers.
At one to two weeks after surgery, you can usually go back to most of your daily activities. You’ll also have a follow-up visit with your doctor. While many people say they feel back to normal soon after surgery, it’s recommended that you avoid strenuous activities, lifting and sex for six weeks to let the vaginal incision fully heal.
