Complete Excision of Pelvic Parasitic Fibroid Using vNotes in Morbidly Obese Patient, case report and review of literature

This case report describes the complete excision of a parasitic fibroid using the vaginal natural orifice transluminal endoscopic surgery (vNOTES) technique in a 49-year-old morbidly obese female patient. The patient presented with heavy menstrual bleeding and pelvic organ prolapse, and imaging revealed a right degenerated subserosal fibroid. Due to her significant comorbidities, a classical vaginal hysterectomy was performed. During the procedure, a parasitic fibroid was identified and excised using the vNOTES technique.The fibroid measured 7.5 ×5.5 cm and was successfully removed without complications. This report presents the first documented case of spontaneous parasitic fibroid excision using vNOTES, highlighting the possibility of using this approach in managing parasitic fibroids, particularly in obese patients.