vNOTES Gynecologic Surgery in Honolulu, HI

vNOTES (vaginal natural orifice transluminal endoscopic surgery) is an advanced minimally invasive gynecologic procedure using the vagina as a surgical access route. The vNOTES technique is most commonly used for hysterectomy procedures, as well as salpingectomy, oophorectomy, and cystectomy procedures.

The American College of Obstetricians and Gynecologists (ACOG) and the American Association of Gynecologic Laparoscopists (AAGL) both have recommended vaginal hysterectomy as the approach of choice whenever feasible.

The board-certified gynecologists at Ko’olau Women’s Healthcare specialize in minimally-invasive vNOTES surgery. If you’re seeking gynecologic surgery using the latest technology, contact us today. Give our Honolulu clinic a call at (808) 888-3449 or call our Kailua clinic at (808) 230-8500.


You play an important role in your surgery and your recovery. Research shows that patients who are well informed about their treatment options enjoy a better outcome and are more satisfied with their results

vNOTES (vaginal natural orifice transluminal endoscopic surgery) is another option to consider for your hysterectomy. It is the next advancement in minimally invasive surgery and does not require abdominal skin incisions.

In the vNOTES procedure, your doctor uses specialized instruments inserted through the vagina instead of creating visible abdominal incisions in the body. This allows your doctor to gain access to the uterus and/or fallopian tubes and ovaries without any visible scarring.

Benefits of vNOTES

  • Shorter Hospital Stay
  • Less Postoperative Pain
  • Shorter Recovery Time
  • Less Pain Medication

What to Expect with vNOTES

Before the Procedure

Your OBGYN will advise you on any pre-surgical tests and give you guidelines for eating, drinking, and taking medications.

During the ProcedurevNOTES.

vNOTES is performed under general anesthesia, so you will be asleep throughout the procedure.

To start, an incision is made in the vagina, and a specialized vNOTES device is placed to provide your doctor access to the uterus and/or fallopian tubes and ovaries. The abdomen is then inflated with carbon
dioxide gas (similar to traditional laparoscopic surgery) to give your doctor the necessary space to see and operate.

Next, a high-definition camera and specialized instruments are inserted through the vNOTES device, allowing your OBGYN to operate with the utmost precision and visualization. Once the surgery is complete, the vNOTES device is removed, the gas is evacuated, and all internal incisions are closed.

After the Procedure

You may be discharged the same day as your procedure. Your doctor will advise you on your recovery and schedule a follow-up appointment.

Talk to an OBGYN in Honolulu, HI

Only a trained doctor can determine whether you are eligible for a vNOTES procedure. All minimally invasive surgical procedures, including vNOTES, present risks to the patient, such as the potential for conversion to a traditional vaginal, laparoscopic, or abdominal approach. These specific risks may only be evaluated in consultation with a doctor experienced in vNOTES procedures. For more information on vNOTES, call our Honolulu office at (808) 888-3449 or our Kailua office at (808) 230-8500 today to schedule an appointment.