vNOTES stands for vaginal Natural Orifice Trans-Endoscopic Surgery. A new hybrid approach to perform minimally invasive gynecological surgery. It utilizes laparoscopic instruments to facilitate surgery through a vaginal (natural orifice) approach. This technique is more difficult to perform than traditional open or laparoscopic surgery BUT provides the patient less pain, quicker surgery, faster recovery and NO ABDOMINAL INCISIONS. This groundbreaking technique provides a new approach to different GYN surgeries.