Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for myomectomy was done for a 31 year old female with menorrhagia. Patient was very concerned about cosmesis. Therefore, this approach was decided. The surgery was uneventful. There were no postoperative complications. Although this technique is feasible, its a difficult surgery with current available instrumentation. Therefore, it should be reserved for selected patients in the hands of surgical team experienced in vNOTES.
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