What Is VOTES?

VOTES stands for Vaginally Assisted Natural Orifice Transluminal Endoscopic Surgery. Instead of traditional laparoscopic surgery, this technique allows access to the uterus, ovaries, or other pelvic organs through the vaginal route, without making large incisions in the abdominal wall. It is an adaptation of the NOTES (Natural Orifice Transluminal Endoscopic Surgery) technique and is becoming increasingly common in gynecological surgery.

Which Gynecological Conditions Can VOTES Surgery Treat?

• Hysterectomy (Removal of the Uterus)
• Myomectomy (Removal of Fibroids)
• Ovarian Cyst Removal
• Tubal Ligation (Fallopian Tube Ligation)
• Treatment of Pelvic Organ Prolapse
• Surgery for Endometriosis and Chronic Pelvic Pain

This method is particularly easier to perform in women who have given birth, as vaginal tissues are more flexible.

Advantages of VOTES Surgery

• ✅ Minimally Invasive: Surgery is performed without large abdominal incisions.
• ✅ Faster Recovery: Patients recover more quickly compared to traditional open or laparoscopic surgeries.
• ✅ Less Pain: Since the abdominal wall is not cut, postoperative pain is reduced.
• ✅ Better Cosmetic Results: No visible external scar, offering an aesthetic advantage.
• ✅ Shorter Hospital Stay: Most patients can be discharged the same day or the following day.

Disadvantages and Risks of VOTES Surgery

• ❌ Not Suitable for Everyone: May not be appropriate for women who have not given birth vaginally or those with anatomical limitations.
• ❌ Technically Challenging: Requires the surgeon to have advanced endoscopic experience.
• ❌ Risk of Infection: There is a risk of infection in vaginal procedures, though sterile techniques minimize this risk.

Recovery After VOTES Surgery

• Patients are usually discharged within 24–48 hours.
• Mild vaginal bleeding may last for a few days.
• Heavy lifting and strenuous physical activities should be avoided in the first few weeks.
• Sexual activity should be resumed only after the doctor’s approval (usually 4–6 weeks).

Conclusion

VOTES is considered a revolutionary method in gynecological surgery. Compared to traditional laparoscopic and open surgeries, it offers less pain, faster recovery, and better cosmetic results. However, since it may not be suitable for every patient, a detailed evaluation is necessary to determine its appropriateness. When performed by an experienced gynecologist, it can be a safe and effective surgical option.