Aga Khan breaks ground with first vaginal NOTES surgery
Aga Khan University Hospital has performed the first Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES), a surgical technique that provides access to treatment of various gynaecological conditions through the vaginal opening without making any external cuts on the abdomen.
A first in the region, vNOTES is the next frontier in gynaecologic minimally invasive surgery where gynaecologists use specialized instruments placed through the vagina and guided by a camera into the pelvic cavity, giving access to the uterus, fallopian tubes and ovaries without the need for abdominal skin incisions.
Dr. Bob Achila, the Lead Surgeon and Consultant Urogynaecologist at the hospital explained that compared to laparoscopic surgery, vNOTES offers several benefits including no visible scars, a shorter hospital stay, reduced postoperative pain, and quicker recovery.
This technique also allows one to resume normal activities with less reliance on pain medication. It is lauded as a cost effective method given that there’s less theatre operating time and shorter hospital stay.
“While both vNOTES and minimally invasive surgery aim to minimize scarring and speed up recovery, vNOTES achieves this by avoiding any external cuts, operating solely through the vagina, whereas minimally invasive surgery involves small abdominal incisions,” said Dr Achila.
The technique is effective for the treatment of various conditions such as hysterectomy, surgeries on the fallopian tubes and ovaries (such as ovarian cysts, ectopic pregnancies, and permanent sterilization), and pelvic organ prolapse.
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In Africa, including East Africa, vNOTES is a relatively new technique and is slowly gaining popularity as medical professionals gain expertise. Globally, it has been in use for about 10 years.
To perform vNOTES, a doctor needs to be specially trained in both minimally invasive surgery and the specific techniques required for vNOTES.
“This is a major medical breakthrough that will improve care for women locally and beyond. Our desire to give patients the best care drives our quest to continuously improve our training, update our skills and remain innovative to keep abreast with the ever-changing healthcare landscape, benchmarked with the best healthcare practices across the globe,” notes Prof. Elkanah Omenge, Chair, Department of Obstetrics and Gynaecology at Aga Khan University Hospital, Nairobi.
AKUH has been a pioneer of many medical breakthroughs and cutting-edge technologies, and this development add-on to the long list of Firsts that the hospital is known for.