Conditions · vNOTES
vNOTES: gynecologic surgery with no abdominal scars
vNOTES is endoscopic surgery performed through the vagina. The camera and instruments enter vaginally, so there are no incisions on your abdomen. It is one of the newest minimally invasive techniques, and few surgeons offer it.
1 minute · 6 questions · no obligation · From USD 5,000
What vNOTES can treat
- Hysterectomy for fibroids, adenomyosis or bleeding
- Removal of benign ovarian cysts and tumors
- Salpingectomy (tube removal)
- Selected endometriosis cases
- Patients who want to avoid visible scars
- Selected patients with obesity
Am I a candidate for vNOTES?
It depends on uterine size, previous surgeries, suspected adhesions or extensive endometriosis, and vaginal anatomy. We decide with your ultrasound and exam; if vNOTES isn't the best option, conventional laparoscopy achieves the same goal through small incisions.
How we treat it
No abdominal incisions
No wounds on the skin of your abdomen and no visible scars.
Fast recovery
In published studies, patients report less post-operative pain and use fewer painkillers than with other approaches.
The safety of laparoscopy
Performed with full endoscopic view of the pelvis, just like laparoscopy.
Recovery: Usually discharged within 24 hours. Desk work in 1–2 weeks; intercourse and exertion as advised, typically at 6 weeks.
Surgical package
From USD 5,000
Your exact price depends on the procedure and is confirmed after your evaluation.
Virtual evaluation: USD 40. Credited toward your package if you have surgery.
Included
- Surgeon's fee
- Surgical assistants
- Surgical nursing
- Anesthesiology
- Minimally invasive equipment
- 1 night hospital stay
Not included
- Lab work and imaging
- Flights and lodging
Your surgeon
Dr. José Nayib Perpuli Hallal
OB/GYN · Minimally invasive gynecologic surgery
- Pioneer of vNOTES surgery in Guadalajara: hysterectomy, myomectomy and ovarian surgery
- Certified by the Mexican Board of Obstetrics and Gynecology
- Fellowship in Minimally Invasive Gynecologic Surgery — ISSA School / ILO
- Lead professor, Basic & Advanced Laparoscopy Fellowship — Instituto Laparoscópico de Occidente
- OB/GYN residency — Centro Médico Nacional de Occidente, IMSS (University of Guadalajara)
- Medical degree with honors — Universidad Autónoma de Baja California
Medical license (cédula): 11064386 · Specialty license: 13761237
Where surgery takes place
Hospital Real San José — Lázaro Cárdenas
All surgeries are performed at Hospital Real San José, Lázaro Cárdenas campus, in Zapopan (Guadalajara): operating rooms equipped for minimally invasive surgery and private rooms.
Av. Lázaro Cárdenas 4149, Jardines de San Ignacio, 45040 Zapopan, Jalisco
Frequently asked questions
What does vNOTES stand for?
Vaginal Natural Orifice Transluminal Endoscopic Surgery. In practice: camera-guided surgery through the vagina.
Does it affect my sex life?
The vagina heals completely; sexual activity resumes after recovery, typically at 6 weeks.
Is it the same as a traditional vaginal hysterectomy?
No. vNOTES uses a camera that shows the whole pelvis and allows precise work on ovaries and tubes, which a traditional vaginal approach does not.
Why wasn't I offered this before?
It requires specific training and equipment, so few gynecologists perform it yet.
Are you a candidate for minimally invasive surgery?
1 minute · 6 questions · no obligation
Check if I'm a candidate