Baekelandt J, et al. - Via this prospective observational study (Canadian Task Force classification II-3) in a non-university teaching hospital, researchers sought to determine the safety and feasibility of vaginal natural orifice transluminal endoscopic surgery (vNOTES) for benign gynaecological indications. In this analysis, inclusion of patient data and perioperative outcomes was done after the vNOTES surgical approach was standardized and made the default route of surgery. During this study period, 1,000 vNOTES cases were performed; among these, hysterectomy (73%) was the most common followed by adnexal surgery (18%) and salpingectomy (4%). They noted a total complication rate of 3.9% (39) of which 1% (10) was intraoperative complications and 2.9% (29) were postoperative complications. This large vNOTES case series had comparable perioperative outcomes for benign gynaecological indications to those reported for other vNOTES procedures in the literature apart from the risk of cystotomy which is a hysterectomy specific risk. As the outcomes are that of a single high-volume surgeon incorporating cases within his respective learning curve of the surgical technique, interpretation should be done accordingly. Since 2015, a prospective complication database has been initiated by the International NOTES Society where all vNOTES surgeons are invited to register their cases.