Introduction Breast cancer is a common malignancy in women and hormone receptor-positive tumors comprise approximately 70% of these cases. In premenopausal women with high-risk characteristics, ovarian suppression is a useful addition to endocrine therapy. Laparoscopic bilateral salpingo-oophorectomy is the preferred surgical option for hormonal ablation. However, it may result in wound complications and prolonged postoperative pain. Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a novel technique that uses natural orifices without abdominal incisions to reduce surgical injuries and improve operative outcomes. This video showcases the use of the vaginal NOTES approach for bilateral salpingo-oophorectomy in an advanced stage breast cancer patient.

Description This video demonstrates the detailed surgical procedure for vNOTES bilateral salpingo-oophorectomy in an advanced stage breast cancer patient. The video starts with patient positioning, followed by the insertion of the laparoscope through the vaginal canal. The fallopian tubes and ovaries are identified and dissected using specialized instruments, and the procedure is completed with removal of the specimens. The video emphasizes the technical aspects of the surgery and provides helpful tips for successful completion of the procedure.

Conclusion/Implications Conclusion/Implication: vNOTES bilateral salpingo-oophorectomy is a minimally invasive surgical technique that can be a safe and effective option for premenopausal women with breast cancer who require ovarian suppression. This approach can help reduce postoperative pain and improve recovery times, which can be especially beneficial for patients with advanced stage disease who may have additional treatment needs. Further studies are needed to fully evaluate the long-term outcomes of this technique, but initial results are promising.