Facilitating V-NOTES bilateral tubal ligation using a laparoscopic fan retractor: A case report

Yılmaz N., Kalkan B.

TAJEV GÜNCEL YAKLAŞIMLAR SEMPOZYUMU, Van, Türkiye, 5 - 06 Haziran 2026, ss.39, (Tam Metin Bildiri)

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Basıldığı Şehir: Van
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.39
  • Erzincan Binali Yıldırım Üniversitesi Adresli: Evet

Özet

Minimally invasive surgical techniques are increasingly preferred in gynecological practice due to their ability to reduce postoperative morbidity, accelerate recovery, and improve patient comfort. Vaginal natural orifice transluminal endoscopic surgery (V-NOTES) has emerged as an innovative approach that enables endoscopic access via the vaginal route, thereby eliminating the need for abdominal incisions. This technique offers several advantages, including reduced postoperative pain, shorter hospital stay, faster recovery, and improved cosmetic outcomes. Bilateral tubal ligation (BTL) is a widely used and effective method for permanent contraception in women. It is based on occlusion of the fallopian tubes to prevent fertilization and has a high efficacy rate. In recent years, bilateral salpingectomy has been proposed as an alternative approach due to its potential to reduce the risk of ovarian cancer in addition to its contraceptive effect. In this study, we present a case of BTL performed using the V-NOTES approach. A 32-year-old multiparous woman (gravida 6, para 6) with a request for permanent contraception underwent bilateral tubal ligation via V-NOTES following appropriate preoperative evaluation. During the procedure, a laparoscopic fan retractor was used to atraumatically elevate the uterus, allowing improved visualization of pelvic anatomical structures. This approach was observed to enhance the surgical field, shorten operative time, and potentially reduce the risk of complications. The operation was completed in a short duration without any intraoperative or postoperative complications. Postoperative analgesic requirement was minimal, early mobilization was achieved, and the patient was discharged on the first postoperative day without any adverse events.