Minimally invasive approaches in ectopic pregnancy surgery: vaginal natural orifice transluminal endoscopic surgery versus conventional laparoscopy

Nur G. Kulhan, Department of Gynaecology and Obstetrics, Konya City Hospital, Konya, Turkey
Ahmet Bilgi, Department of Gynaecology and Obstetrics, Selcuk University Medical Faculty, Konya, Turkey
Cetin Celik, Department of Gynaecology and Obstetrics, Selcuk University Medical Faculty, Konya, Turkey
Fazil Avci, Department of Gynaecology and Obstetrics, Selcuk University Medical Faculty, Konya, Turkey
Mehmet Kulhan, Department of Gynaecology and Obstetrics, Selcuk University Medical Faculty. Konya, Turkey

Objectives: The objective of the study was to compare the efficacy and safety of vaginal natural orifice transluminal endoscopic surgery (V-NOTES) and conventional laparoscopy in the surgical management of ectopic pregnancy. Methods: A retrospective case–control study was conducted, including 40 patients diagnosed with ectopic pregnancy, treated either with V-NOTES (n = 20) or conventional laparoscopy (n = 20). Outcomes assessed included operative time, blood loss, post-operative pain scores, length of hospital stay, and complication rates. Results: No significant differences were observed between the two groups in terms of operative time, blood loss, and complication rates. However, V-NOTES resulted in significantly lower postoperative pain scores (Visual Analog Scale: 2.1 ± 1.0 vs. 4.3 ± 1.1; p = 0.01) and reduced opioid usage compared to conventional laparoscopy. Conclusions: V-NOTES appears to be a non-inferior alternative to conventional laparoscopy in ectopic pregnancy surgery, with comparable surgical safety and enhanced post-operative comfort. Further research with larger cohorts is recommended to confirm these findings.

Keywords: Ectopic pregnancy. Vaginal natural orifice transluminal endoscopic surgery. Conventional laparoscopy. Minimally invasive surgery. Surgical outcomes.