Independence Health System Now Offering Innovative Surgery Option for Hysterectomy Patients

GREENSBURG, PA, January 31, 2024 … A new minimally invasive option for hysterectomy procedures and pelvic organ conditions is now available to Independence Health System patients. Known as vNOTES (vaginal natural orifice transluminal endoscopic surgery), the advanced gynecologic technique provides many benefits to female patients, including no abdominal wall incisions, which contributes to a shorter hospital stay, less postoperative pain, no visible scars, and a faster recovery time. 

 James Nolfi, DO, FACOOG, an obstetrician and gynecologist practicing with Independence Health System-Westmoreland area, has been specially trained on this innovative minimally invasive approach to hysterectomy and other common gynecologic procedures. Dr. Nolfi is the first physician in the health system and one of only eight in Pennsylvania to perform this technique. 

“As a surgeon, I am continually seeking education and training to offer my patients the best course of action for their care,” said Dr. Nolfi.  “Among the benefits of vNOTES is the increased opportunity to repair problems such as urinary leakage and pelvic organ prolapse vaginally. Recovery is faster and outcomes are better than traditional forms of hysterectomy.” 

The American College of Obstetricians and Gynecologists and the American Association of Gynecologic Laparoscopists have recommended vaginal hysterectomy, whenever feasible, as the approach of choice. 

“Surgical societies see the benefits of minimally invasive vaginal hysterectomy, but the procedure is performed less frequently because of the difficulties involved in seeing and accessing critical anatomy,” noted Dr. Nolfi. “vNOTES helps solve these challenges through the use of innovative technology designed to enhance patient outcomes. I expect this technique will become more readily available as surgeons everywhere become more familiar with its benefits and seek training.” 

The vNOTES technique, which uses the vagina as a surgical access route, is the newest approach to hysterectomy procedures. For the surgery, a vNOTES device known as the GelPOINT® V-Path transvaginal access platform is placed through the vagina into the pelvic cavity, giving access to the uterus, fallopian tubes and ovaries. The vNOTES device is the means by which the abdomen is inflated with carbon dioxide gas to give the surgeon the space needed to see and operate. A high-definition camera and specialized instruments are inserted through the device, allowing the surgeon to operate with precision and high visualization. Once the surgery is completed, the vNOTES device is removed and the gas is evacuated. 

vNOTES for gynecologic applications emerged internationally in 2012, and clinical trials followed in 2016 and 2021.  In the United States, the Food and Drug Administration approved the GelPOINT® V-Path transvaginal access platform for vNOTES in 2019, and the technique has grown in popularity among surgeons since 2020 as education and training courses become more widely available. 

“At Independence Health System, we take pride in being able to individualize our approach for each patient because we have surgeons trained in all types of hysterectomies,” noted Randi Turkewitz, MD, FACOG, chair of the Department of Obstetrics and Gynecology and service line leader for women’s health services for Independence Health-Westmoreland area.  “From vNOTES, to total laparoscopic hysterectomy, robot-assisted surgery to an open procedure, the choices are many, the experience extensive, and the patient’s best possible outcome always guides the discussion and plan of care.”   

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Nationally recognized for quality care, Independence Health System comprises Butler Memorial, Clarion, Frick, Latrobe and Westmoreland Hospitals with a combined bed count of 925.  With more than 1,000 physicians and advanced practice providers and 7,300 employees, the System is now the third largest in western Pennsylvania serving a population base of 750,000 in a footprint spanning more than 10 counties.  
 
The System includes tertiary programs that are rated among America’s best for cardiac care and surgery by Healthgrades in its Top 100 designations. In similar fashion, the prestigious Society of Thoracic Surgeons (STS) bestowed its top three-star rating. Historically, less than 10 percent of programs within the STS data base achieve this elite standing. The hospitals of Independence Health System also have earned a host of accolades from such prestigious outlets and sources as US News and World Report, Newsweek Magazine, the American College of Radiology, the American College of Cardiology, the American College of Surgeons, the Joint Commission, Leapfrog and the American Heart/Stroke Association. 

Locally owned and locally controlled, Independence Health System offers its patients low-cost, high-quality care across the care spectrum in such specialties as cardiology, cardiovascular and thoracic surgery, orthopedics and sports medicine, minimally invasive and robotic surgery, women’s health and obstetrics, emergency medicine, behavioral health and primary care. Its network of outpatient centers sees more than 1.2 million visits annually. The homecare division further supports patients at all stages of life with home health and hospice services.   
 
Independence Health System continues to change the healthcare landscape in western Pennsylvania by meeting patient needs through superb physician expertise, outstanding nursing, the latest in technology and programmatic depth. 

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