The Erkilinc Technique for vNOTES Hysterectomy: A Speculum-assisted Approach Without Prior Vaginal Dissection: A 163-Case Series
Journal of Minimally Invasive Gynecology, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jmig.2026.09.004
- Dergi Adı: Journal of Minimally Invasive Gynecology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Anahtar Kelimeler: Hysterectomy, Speculum-assisted technique, vNOTES
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To describe a novel speculum-assisted glove-port technique for vNOTES hysterectomy (Erkilinc technique) and to evaluate its feasibility, safety, and learning curve in patients undergoing surgery for benign indications. Design: Retrospective case series. Setting: Tertiary referral center. Participants: A total of 163 consecutive women undergoing vNOTES hysterectomy for benign indications between January 2019 and November 2023. Interventions: vNOTES hysterectomy using a speculum-integrated glove-port system allowing complete laparoscopic execution without prior vaginal dissection. Measurements and Main Results: The mean surgical time was 70.6 ± 24.5 minutes. The mean uterine weight was 280.9 ± 214 g. The mean decrease in hemoglobin was 0.9 ± 1.4 g/dL. The overall complication rate was 3.1%, with no ureteric or bowel injuries observed. The mean VAS scores were 4.7 at 4 hours and 3.3 at 24 hours. Learning curve analysis demonstrated a significant reduction in surgical time over successive cases, with procedural proficiency achieved after approximately 45 cases based on CUSUM analysis. Surgical times were comparable to those reported for Alexis-based systems. Conclusion: The Erkilinc technique represents a reproducible and efficient vNOTES approach that avoids prior vaginal dissection and eliminates the need for internal wound retractors. This technique may expand the applicability of vNOTES to nonprolapsed uteri while maintaining safety and operative efficiency.