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

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 post-operative 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.