This retrospective cohort study at a French Tertiary University hospital compared standard laparoscopic hysterectomies with vNOTES hysterectomies for individuals with big uteri (weight >280g). The study comprised 54 patients who had vNOTES hysterectomy and 52 patients who had conventional laparoscopic hysterectomy for big uteri. The researchers looked at uterine weight, mode of delivery for previous pregnancies, history of abdominal surgery, indication for hysterectomy, associated procedures, operative time, complications, volume of intraoperative bleeding, and length of postoperative hospital stay. In terms of patient characteristics, the results showed that both groups were equivalent, with the vNOTES group having a slightly greater mean uterine weight. However, there was a considerable reduction in operative time in the vNOTES group when compared to the control group.

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