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BACKGROUND: This study aimed to develop a novel antiprolapse surgical technique utilizing minimally invasive methods with lateral suspension in natural orifice surgeries. AIMS: The primary objective of this study was to describe a modified V-Notes lateral suspension (VNLS) technique as a viable alternative for antiprolapse surgery. STUDY DESIGN: This was a prospective clinical trial evaluating a new surgical technique. METHODS: Patients indicated for lateral suspension underwent the procedure using the V-Notes technique through natural orifices. No additional incisions were made on the anterior abdominal wall, except for the mesh exit points. RESULTS: Post-operation, the only incisions present were the two lateral mesh outlet incisions on the anterior abdominal wall. Additionally, there was no need for peritonization as the Alexis wound protector/retractor was used extraperitoneally. The outcomes were comparable to those achieved with laparoscopic lateral suspension (LLS). The VNLS technique demonstrated favorable results, including shorter hospital stays and improved cosmetic outcomes compared to traditional LLS. This innovative approach has the potential to become the new gold standard in antiprolapse surgery, providing benefits such as minimal invasiveness and enhanced aesthetics. CONCLUSION: While the optimal treatment for pelvic organ prolapse remains undetermined, natural orifice surgeries like V-Notes offer promising advantages, including reduced invasiveness and superior cosmetic results, suggesting their potential for future standard practice.
Bulutlar et al. (Sat,) studied this question.