Advanced surgery technique a new option for women

A new hysterectomy procedure that holds the hope of reduced time in hospital, faster recovery, less pain and no visible scaring is now available for women in northern Tasmania.

Introducing the vNOTE procedure

Known as vNOTE (or Vaginal Natural Orifice Transluminal Endoscopic Surgery), it does not require surgical cuts to the abdomen, large or small. Instead, a high-definition camera and specialised instruments are inserted through a special device placed in the vagina.

The first two vNOTE procedures were done on the same day in March at Calvary St Vincent’s Hospital by Launceston gynaecologist Dr Ben Dhanaraj, who is also the first to be accredited to perform the surgery in northern Tasmania. Both women went home the following day, have healed well and reported a good recovery. His next cases are booked for July.

Dr Dhanaraj said the procedure was the next advancement in minimally invasive surgery and another option to consider for women needing surgery to remove reproductive organs.

“Most hysterectomies these days are done using some form of internal or external laparoscopic assisted surgery,” Dr Dhanaraj said.

“vNOTES is a relatively new technique, certainly in Australia, and is the next step in making this type of surgery even less invasive and disruptive for women.”

That was certainly the case for busy business owner and mother of two active boys, Anafa Fok Chak.

Anafa’s story

“There was some discomfort and weakness that meant I couldn’t do much in the first few weeks, but that was to be expected. I had very little actual pain and what there was only lasted a few days,” said Ms Fok Chak, owner of Specsavers in Devonport.

She was working on a laptop from her lounge at home the week after her surgery, and was back in the store within about three and a half weeks, though gingerly at first.  Ms Fok Chak was able to largely resume life as normal from about five weeks, and by early May was thinking about starting back at her gym.

Having needed the care of a gynaecologist since her teens, Ms Fok Chak said she was already considering a hysterectomy by the time she spoke with Dr Dhanaraj, and was undaunted at the idea of being one of the first to have the new procedure.

“For me it was the right decision to have a hysterectomy and I’m glad this procedure was an option for me.”

More information

Gynaecological problems are a major, if often hidden health issue for women. It is estimated that one in three women globally over the age of 45 have had a hysterectomy, and approximately 32,000 hysterectomies are performed each year in Australia.

Dr Dhanaraj said the expected time for full internal healing with any hysterectomy is about six weeks, no matter the technique used.

He said results to date in Australia and other countries had shown that because it is minimally invasive and there are no incisions, recovery time with vNOTES can be quicker, especially in terms of the functions women can do in the weeks after, and there seems to be less pain and need for pain medication. It also takes less time in surgery.

General Manager of Calvary St Vincent’s and Calvary St Luke’s hospitals in Launceston, Dr Zoe Bishop, said vNOTES was an example of the innovation in surgery conducted at the two hospitals to benefit and improve the lives of patients from around northern Tasmania.

“Dr Dhanaraj works with an experienced and highly skilled surgical team at Calvary St Vincent’s who have been keen to learn the new procedure and processes required in the operating theatre,” Dr Bishop said.

While he can foresee eventually doing the procedure as day surgery, Dr Dhanaraj is taking a cautious and selective approach initially.

“The procedure won’t work for every patient, depending on their clinical circumstances, but it is now another option available.”