In conclusion, this is the first case to combine vNOTES with the HoTT technique, enabling a minimally invasive, mesh-free, and anatomically precise prolapse repair. vNOTES offers precise dissection and sacral fixation using a vaginal approach. This should lead to fast recovery and reduced postoperative pain. A retroperitoneal approach allows faster operation times and prevents intraperitoneal adhesions. This technique is promising for patients desiring a mesh-free approach. This innovative approach may serve as a promising alternative to conventional techniques in selected patients.
Rüdiger et al. (Fri,) studied this question.