【Abstract】 Objective To compare the clinical effects of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and traditional laparoscopic hysterectomy to explore the feasibility and safety of vNOTES hysterectomy. Methods Ninety-eight patients who underwent total hysterectomy for benign diseases of the uterus and met the inclusion criteria from August 2019 to June 2021 were included in the author"s team. They were divided into two groups according to different surgical methods, vNOTES total hysterectomy (vNOTES group) 48 Cases, 50 cases of traditional porous laparoscopic total hysterectomy (traditional porous laparoscopic group). Observe the operation time, intraoperative bleeding, postoperative exhaust time, hemoglobin decline before and after the operation, visual analogue scale (VAS) for pain at 24 hours and 72 hours after operation, 72 hours postoperative beauty satisfaction score, hospitalization days, etc. And followed up 2 months after the operation of the patient"s stump healing, patient satisfaction with cosmetics, etc.Results Of the 48 cases in the vNOTES group, 47 cases successfully completed the operation, and 1 case was transferred to traditional laparoscopic surgery. In the traditional laparoscopic group, the operation was successfully completed without changing the surgical approach. All patients had no intraoperative or postoperative complications, no blood transfusion cases, and reexamination of the vaginal stump healed well 2 months after the operation.There was no significant difference in average intraoperative blood loss, hemoglobin decline before and after the operation, postoperative exhaust time and the hospital stay between the two groups of patients (P>0.05).The operation time was (117.9±10.0) min in the vNOTES group and (104.1±17.8) min in the traditional laparoscopic group, and the difference was statistically significant (P<0.05); VAS scores at 24 hours and 72 hours after surgery were (2.5±0.7) points and (1.8±0.6) points in the vNOTES group, and (3.9±1.0) and (1.9±0.5) points in the traditional laparoscopic group, and 3 days after surgery and The two-month cosmetic satisfaction score vNOTES group was (93.4±1.4) points, (96.3±1.1) points, and the traditional laparoscopy group was (92.9±1.4), (94.5±1.2) points. The observation indexes of the two groups were compared respectively. There was a statistically significant difference in the 24-hour VAS score and the beauty satisfaction score 2 months after the operation (P<0.05).Conclusion vNOTES total hysterectomy is a safe and feasible method;Compared with traditional laparoscopic surgery, vNOTES has advantages in reducing early postoperative pain and higher long-term cosmetic satisfaction; and it has a good application and promotion prospect.