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The technique to perform adnexectomy for adnexal masses has shifted over the last decades, from open surgery towards minimally invasive approaches. At the same time caution is warranted to prevent perioperative intra-abdominal spilling of cyst content which can be a challenge especially for very large masses. vNOTES (vaginal Natural Orifice Transluminal Endoscopic Surgery) combines a vaginal approach with endoscopic overview in performing gynaecological surgery without abdominal scarring. The aim of the video is to demonstrate a vNOTES technique for safely bagging very large adnexal masses., Competing Interests: Declaration of competing interest The authors have no conflict of interest. Jan Baekelandt and Andrea Stuart disclose consultancy/ teaching for Applied Medical., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Urinary incontinence affects 25-45 % of women with the gold standard surgical approach being placement of mid-urethral synthetic slings; tension-free vaginal tape (TVT) and trans-obturator tape (TOT). Due to the controversies regarding vaginal mesh the last decade, an increasing demand has evolved for incontinence treatment without vaginal synthetic mesh. The short term results of autologous rectus fascia sling for TOT surgery have shown similar success rates compared to those after the use of synthetic mesh, but the harvesting of the mesh is less minimally invasive and is associated with longer surgical time. vNOTES is a combination of a vaginal entrance to the abdomen and endoscopy via the vagina. The aim with the video is to show a new surgical technique with a fully vaginal, scarless vNOTES approach for harvesting the posterior rectus fascia for TVT and TOT procedures., Competing Interests: Declaration of competing interest The authors have no conflict of interest. Jan Baekelandt and Andrea Stuart declares consultancy/ teaching for Applied Medical., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Introduction and Hypothesis: The Manchester procedure is a classic native tissue prolapse technique with low recurrence and low complication rate. vNOTES (vaginal natural orifice transluminal endoscopic surgery) is a vaginal approach to enter the intra or retroperitoneal space, with the guidance of endoscopic visualization. Different studies have shown women to prefer uterus-preserving correction of prolapse over hysterectomy, as they worry about complications, impact on sexual function and self- sense. At the same time, an increasing caution and awareness of mesh related complications has evolved, giving a need for the development of additional non-mesh uterus preserving surgical techniques for prolapse. The aim with the video is to show a new surgical technique for prolapse, combining the Manchester procedure with vNOTES retroperitoneal non-mesh promontory hysteropexy., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest. Jan Baekelandt and Andrea Stuart declares consultancy/ teaching for Applied Medical., (Copyright © 2023. Published by Elsevier Masson SAS.)