What question did this study set out to answer?

To explore a novel approach combining vNOTES with the HoTT technique for prolapse repair without mesh.

synapse

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synapse

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February 21, 2026Open Access

vNOTES retroperitoneal uterosacropexy using the semitendinosus tendon

Key Points

To explore a novel approach combining vNOTES with the HoTT technique for prolapse repair without mesh.
Performed retroperitoneal uterosacropexy using the semitendinosus tendon
Utilized vNOTES for a minimally invasive vaginal approach
Assessed operation times, postoperative pain, and recovery progress
Achieved anatomically precise prolapse repair without mesh
Demonstrated faster recovery times than traditional techniques
Reduced postoperative pain reported in initial assessment

Abstract

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.

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