Handx Robotic Arm Assisted vNOTES Hysterectomy With Contained Transvaginal Specimen Retrieval

• Published in: Journal of minimally invasive gynecology Vol. 31; no. 11; p. S39
• Main Authors: Naval, S, Naval, R
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-11-2024
• ISSN: 1553-4650
• DOI: 10.1016/j.jmig.2024.09.151

To demonstrate a case of successful vNOTES (vaginal natural orifice transluminal endoscopic surgery) hysterectomy for a large uterus using a novel hand held robotic surgical arm assistance.
Stepwise demonstration using a narrated video of hand-held robotic arm assisted vNOTES hysterectomy with right salpingo-oophorectomy and left salpingectomy followed by contained transvaginal specimen retrieval.
Naval Multi Specialty Hospital (Tertiary Care Private Hospital)
A 44-year-old female with refractory abnormal uterine bleeding. She had a history of two normal vaginal deliveries and a tubal ligation surgery. Transvaginal ultrasound revealed multiple fibroid uterus and right ovarian haemorrhagic cyst.
HandX® robotic arm assisted vNOTES hysterectomy, right salpingo-oophorectomy and left salpingectomy with contained transvaginal specimen retrieval.
The specimen weighed 824 grams. The duration of the surgery was 88 minutes and total blood loss was about 76 ml. There were no intraoperative/ postoperative complications. The patient was discharged on day 2.
HandX® hand held robotic arm offers significant articulation and multiple degrees of freedom compared to the straight stick instruments. This articulation is helpful in vNOTES as it offers better dexterity to the surgeon and prevents swording of the instruments. Such a robotic arm can be helpful in difficult vNOTES procedures like a large uterus hysterectomy. The feasibility and the utility of this device in vNOTES procedure should be further evaluated.