Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is a relatively modern approach. Different disciplines have used natural orifices to insert endoscopes as a way to provide a minimally invasive approach to multiple procedures. The transvaginal approach is probably one of the least invasive access points into the abdomen. In a similar way laparoscopic surgery changed the history of minimally invasive surgery in the 1980-1990s, vNOTES is reshaping the definition of minimally invasive gynecologic surgery. The vNOTES approach provides surgeons with an alternative access point to the abdomen with quicker recovery times, faster surgery, better cosmetic outcomes and better anesthesia requirements with less cardiopulmonary compromise during the surgery.

This is the first surgical atlas of vNOTES surgery in the world that describes different transvaginal laparoscopic procedures for benign and malignant gynecology. Opening chapters present the history of the approach, relevant pelvic anatomy, perioperative considerations, candidate identification and operating room set-up. Stepwise chapters on procedures follow, including hysterectomy, gender affirmation, adnexal surgery, myomectomy and more. Closing chapters discuss the teaching of vNOTES, gynecological oncology, robotic surgery and more. The book is authored and edited by leading experts in the world including multiple photographs and steps to provide surgeons guidance into vNOTES.

Omar F. Dueñas Garcia, MD, DHA, MPH, MS, Department of Obstetrics and Gynecology, West Virginia University, Morgantown, WV, USA

Jan Baekelandt, MD, PhD, Department of Gynecologic Oncology, Imelda Hospital, Bonheiden, Belgium

Grover May, MD, Department of Obstetrics and Gynecology, State of Franklin Healthcare Associates, Johnson City, TN, USA