Using robotic single-port vNOTES for gynaecological oncology: omentectomy in a patient with an ovarian granulosa cell tumor—a case study

Abstract

BACKGROUND: Robotic single-port transvaginal natural orifice transluminal endoscopic surgery (RSP-vNOTES) is an emerging minimally invasive approach that combines the advantages of robotic surgery with scarless transvaginal access. Its application in gynecologic oncology remains limited, particularly for omentectomy during ovarian cancer staging. METHODS: We present the case of a 45-year-old woman with an ovarian granulosa cell tumor (GCT) who underwent supplemental staging surgery following unilateral oophorectomy. Using a single-port robotic system via the transvaginal route, hysterectomy, right salpingo-oophorectomy, and omentectomy were performed. Key technical steps included enhanced visualization with gauze placement and use of an additional robotic arm for omental traction. RESULTS: The procedure lasted 2 hours and 10 minutes with an estimated blood loss of 50 mL. No intraoperative or postoperative complications occurred. The patient did not require postoperative analgesics and was discharged on postoperative day 3. Final pathology confirmed absence of omental metastasis. CONCLUSION: This case demonstrates the feasibility and safety of RSP-vNOTES for omentectomy in gynecologic oncology. The technique offers potential benefits including reduced abdominal trauma, faster recovery, and superior visualization for complex dissections. While further studies are necessary to validate long-term oncologic outcomes, RSP-vNOTES may represent a promising minimally invasive option for selected patients requiring ovarian cancer staging surgery.