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Update on Minimally Invasive Gynecologic Surgery
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Update on Minimally Invasive Gynecologic Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 20 March 2026 | Viewed by 468

Special Issue Editor

Dr. Greg J. Marchand

E-Mail Website
Guest Editor
Marchand Institute for Minimally Invasive Surgery, Mesa, AZ 85209, USA
Interests: minimally invasive gynecologic surgery; single incision laparoendoscopic surgery (SILS); morcellation; laparoscopic-assisted vaginal hysterectomy (LAVH); enhanced recovery after surgery (ERAS) protocols

Special Issue Information

Dear Colleagues,

Minimally invasive gynecologic surgery (MIGS) is experiencing a transformative renaissance, driven by groundbreaking advancements that enhance precision, reduce patient recovery times, and improve cosmetic outcomes. Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) represents a paradigm shift, combining the benefits of vaginal and laparoscopic approaches to perform procedures like hysterectomy and salpingectomy without abdominal incisions, leading to less pain, faster recovery, and no visible scarring. The integration of robotic assistance in vNOTES (RV-Notes) further refines this technique by offering enhanced visualization and dexterity, particularly for complex cases. Concurrently, single-port laparoscopic surgery (SPLS) and single-port robotic systems, such as the da Vinci Single-Site platform, have revolutionized MIGS by minimizing incisions to a single umbilical site, improving cosmesis, and reducing complications like postoperative pain and hernia risk.

This surgical renaissance in MIGS presents an unparalleled opportunity for researchers and clinicians to contribute to a landmark Special Issue of the Journal of Clinical Medicine. This collection promises to be a definitive resource, capturing the cutting-edge advancements in vNOTES, RV-Notes, single-port robotic systems, and SPLS. I warmly invite my colleagues to submit their original research and reviews to this prestigious journal, which is 100% indexed in PubMed and MEDLINE, ensuring global visibility and impact. The Journal of Clinical Medicine’s rigorous peer review, broad readership, and high citation potential make this MIGS-focused issue the ideal platform to showcase your contributions to our rapidly evolving field. Join us in shaping the future of gynecologic surgery by submitting to this notable issue!

Thank you,

Dr. Greg J. Marchand
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • minimally invasive gynecologic surgery (MIGS)
  • obstetrics and gynecology
  • single-port laparoscopy
  • hysterectomy
  • robotic surgery

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Published Papers (2 papers)

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Review

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13 pages, 351 KB  
Review
Indications and Limitations of vNOTES for the Surgical Staging of Early-Stage Ovarian Cancer: A Narrative Literature Review
by Vasilios Lygizos, Dimitrios Efthymios Vlachos, Dimitrios Haidopoulos, Aikaterini Karagouni, Antonia Varthaliti, Maria Fanaki, Nikolaos Thomakos, Christos Damaskos, Nikolaos Garmpis, Gerasimos Tsourouflis, Stylianos Kykalos, Stavros Athanasiou and Dimitrios Dimitroulis
J. Clin. Med. 2025, 14(24), 8873; https://doi.org/10.3390/jcm14248873 - 15 Dec 2025
Viewed by 84
Abstract
Introduction: Natural Orifice Transluminal Endoscopic Surgery (NOTES) via the vagina (vNOTES) has recently appeared on the gynecology horizon as a fresh minimally invasive approach. Although vNOTES for benign adnexal conditions is being increasingly employed, very limited experiences exist for its application in ovarian [...] Read more.
Introduction: Natural Orifice Transluminal Endoscopic Surgery (NOTES) via the vagina (vNOTES) has recently appeared on the gynecology horizon as a fresh minimally invasive approach. Although vNOTES for benign adnexal conditions is being increasingly employed, very limited experiences exist for its application in ovarian tumors. In this review, the current state of vNOTES applicability for borderline ovarian tumors (BOTs) and estimated early-stage epithelial ovarian cancer (EOC) is assessed. Methods: A narrative literature review was performed to examine operative viability, perioperative safety and functional outcomes, and oncologic details as documented for patients with ovarian tumors undergoing vNOTES. Results: In the current literature, vNOTES has been utilized for adnexectomy, hysterectomy, infracolic omentectomy, peritoneal biopsies, and sampling of selective pelvic lymph nodes in carefully selected patients. The perioperative parameters—bleeding, perioperative pain, and length-of-stay indicators—have been satisfactory with minimal complications. For BOT, vNOTES can meet the requirements for all surgical goals except lymphadenectomy for metastasis evaluation for systemic management. In this context, lymphadenectomy is not necessary for BOT and therefore is no contraindication for vNOTES. However, for invasive EOC, this is a significant drawback as there is no lymphadenectomy for the evaluation and management for this complex subgroup. The oncology follow-up is prematurely limited and is heterogeneous and underpowered. Conclusions: Based on current available data, vNOTES is possible in a selected group of patients with borderline ovarian tumors and in patients with adnexal lesions that are believed to be in early-stage disease based upon imaging studies. For the treatment of invasive epithelial ovarian cancer, vNOTES should not be considered an independent staging procedure at any FIGO stage, but it might find a supplemental place in the setting of a hybrid procedure in a highly selected group of patients in an experienced center. Full article
(This article belongs to the Special Issue Update on Minimally Invasive Gynecologic Surgery)
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15 pages, 2436 KB  
Systematic Review
Laparoendoscopic Single-Site Surgery Versus Conventional Laparoscopic Surgery in Ovarian Cystectomy: A Meta-Analysis
by Greg J. Marchand, Ahmed T. Abdelsattar, Daniela Gonzalez Herrera, Mckenna Robinson, Emily Kline, Sarah Mera, Michelle Koshaba, Nidhi Pulicherla and Ali Azadi
J. Clin. Med. 2025, 14(24), 8739; https://doi.org/10.3390/jcm14248739 - 10 Dec 2025
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Abstract
Background/Objectives: To systematically compare the effectiveness and safety of laparoendoscopic single-site surgery (LESS) versus conventional multi-port laparoscopic surgery (CLS) for ovarian cystectomy in women with benign ovarian cysts, focusing on operative outcomes, postoperative pain, and recovery parameters. Methods: A comprehensive search [...] Read more.
Background/Objectives: To systematically compare the effectiveness and safety of laparoendoscopic single-site surgery (LESS) versus conventional multi-port laparoscopic surgery (CLS) for ovarian cystectomy in women with benign ovarian cysts, focusing on operative outcomes, postoperative pain, and recovery parameters. Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov, and SCOPUS from inception to 1 June 2024. Randomized controlled trials and observational studies directly comparing LESS with CLS for benign ovarian cystectomy (excluding adnexectomy) were included. Primary outcomes were operative time, blood loss, hospital stay, postoperative pain, and complications. Data were pooled using mean differences (MD) or risk ratios with 95% confidence intervals in fixed- or random-effects models according to heterogeneity. Results: Nine studies (1 randomized trial, 8 observational; total n = 1368 patients: 702 LESS, 666 CLS) were included. LESS was associated with longer operative time (MD 9.42 min, 95% CI 3.47–15.37, p = 0.002) but shorter hospital stay (MD −0.26 days, 95% CI −0.39 to −0.14, p < 0.001). No significant differences were found in blood loss, postoperative analgesic requirements, hemoglobin drop, or complication rates. Postoperative pain scores at 6 and 24 h were similar, although adjusted analysis suggested marginally lower pain at 24 h with LESS (MD −0.20, p = 0.05). Conclusions: Laparoendoscopic single-site ovarian cystectomy is a safe and reliable alternative to conventional multi-port laparoscopy, offering the advantage of shorter hospital stay despite slightly longer operative time, with equivalent safety profile and postoperative pain. LESS expands minimally invasive options in benign gynecologic surgery 1.1 s. Full article
(This article belongs to the Special Issue Update on Minimally Invasive Gynecologic Surgery)
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