**1. Introduction**

Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) incorporates a number of different techniques and strategies to permit minimally invasive surgery through the natural orifice of the vagina. It is a hybridization of laparoscopic and transvaginal approaches with the advantages of each. While some of the earliest endoscopic techniques were performed through the posterior vagina and referred to as culdoscopy, only since the adaptation of multi-port single-incision laparoscopy to a transvaginal approach has the full value of this technique begun to be appreciated. Almost any laparoscopic procedure can now be performed transvaginally which can significantly reduce patients' postoperative discomfort, time to recovery, length of hospitalization, and without visible scar.
