ABSTRACT Background Tubal ligation is a common permanent contraception method. Vaginal natural orifice transluminal endoscopic surgery (vNOTES) offers a scarless alternative to laparoscopy, but comparative evidence for interval tubal ligation is limited. Objective To compare surgical outcomes and recovery between vNOTES and conventional laparoscopic tubal ligation. Methods Retrospective cohort at a tertiary center (August 2024–May 2025). Women aged 30–50 seeking permanent contraception with ASA ≤ 3 were included. Exclusions: prior pelvic surgery or known pelvic pathology, salpingectomy or non‐contraceptive indications (e.g., hydrosalpinx), concomitant procedures, incomplete records. Patients were grouped by technique: vNOTES ( n = 20) or laparoscopy ( n = 27). Outcomes: operative time, hospital stay, time to mobilization, analgesia use, Δhemoglobin/Δhematocrit, complications. Tests: t‐test/Mann–Whitney, Chi‐square/Fisher; effect sizes (Cohen's d) and 95% CIs reported ( α = 0.05). Results Baseline demographics were comparable. Operative time did not differ (mean difference −3.77 min, 95% CI −9.70 to 2.15; p = 0.199; d = −0.32). vNOTES was associated with shorter hospitalization (−3.40 h, 95% CI −6.51 to −0.29; p = 0.033; d = 0.47), earlier mobilization (−0.80 h, 95% CI −1.27 to −0.33; p 0.40). One vNOTES case required conversion to laparoscopy due to adhesions; no conversions occurred in the laparoscopy group. Conclusions vNOTES and laparoscopy are both safe for interval tubal ligation. vNOTES confers clinically meaningful recovery advantages—shorter hospitalization, faster mobilization, and reduced analgesic need—while maintaining comparable operative time and blood loss surrogates. These findings support vNOTES as a promising, patient‐centered alternative.
Denizli et al. (Thu,) studied this question.
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