Hysterectomy
Removal of the uterus for benign conditions such as fibroids or adenomyosis, when indicated. Removing the uterus does not always require removing the ovaries.
Established indicationGYNAECOLOGICAL SURGERY · PALMA DE MALLORCAAdvanced surgery.
Advanced surgery.
No abdominal incisions.
Discover vNOTES: gynaecological surgery through the vaginal route, with endoscopic vision and care built around you. Dr. Rubèn Baltà at Hospital Quirónsalud Palmaplanas.
Individual assessment · Personalised quotation
Dr. Rubèn Baltà i ArandesGynaecological surgeon · vNOTES specialist
HOSPITAL QUIRÓNSALUD PALMAPLANAS · PALMA DE MALLORCA
vNOTESNo incisions
in the abdomen
in the abdomen
PalmaSurgery in a
hospital setting
hospital setting
With youBefore, during
and afterwards
and afterwards
01 / UNDERSTANDING vNOTES
A different approach to your care.
vNOTES combines vaginal surgery with an endoscopic camera. It accesses the pelvis through an internal vaginal incision, without incisions in the abdominal skin when the procedure is completed by this route.
Science and transparency ↗Vaginal access
The vagina provides access. A device allows the camera and surgical instruments to be introduced.
Camera and instruments
The team views the pelvic organs on a monitor and adapts the operation to your anatomy.
Closure and recovery
The vaginal incision is closed at the end. Even without an abdominal wound, this is surgery and recovery remains essential.
No abdominal incisions are needed when surgery is completed through this route. There is an internal incision; a change of approach may be necessary for safety.
02 / TREATMENT OPTIONSOne approach.
One approach.
Different possibilities.
Suitability depends on your diagnosis, anatomy and personal goals. The best route is the one that safely addresses your condition.
Ovaries and fallopian tubes
Surgery for benign ovarian cysts, removal of adnexa or fallopian tubes. Suspected cancer requires a specific oncological plan.
Selected casesPelvic floor
Prolapse repair and apical suspension, including uterosacral ligament suspension, according to the defect and functional needs.
Individual reconstructionPelvic assessment
Endoscopic inspection of the pelvic cavity when there is a surgical indication. It does not replace ultrasound or serve as a routine check-up.
Specific diagnostic indicationEctopic pregnancy
An option for selected tubal ectopic pregnancies in stable patients. Urgency, bleeding and anatomy determine the safest route.
Strict patient selectionEndometrium and sentinel nodes
For apparently early-stage endometrial cancer, surgery and pelvic lymph node assessment through vNOTES may be considered in specialist care.
Evolving evidence03 / BENEFITS IN CONTEXTLess impact.
Less impact.
The same focus on safety.
No abdominal wounds
Avoids skin incisions and discomfort associated with abdominal ports if surgery is completed through vNOTES.
Early recovery
Some studies report less initial pain and shorter hospital stays compared with laparoscopy in selected patients.
A plan for you
The approach is part of a preparation, pain management and follow-up programme tailored to your procedure.
Benefits are not guaranteed and vary by operation. vNOTES has not been shown to be superior for every outcome or every patient. See the references below.
04 / AN INFORMED DECISION
Is it right for me?
We review your medical history, examination and imaging. Previous caesarean delivery, obesity or no prior vaginal births do not automatically rule out this approach.
Risks and alternatives
Risks include bleeding, infection, injury to the bladder, ureters, bowel or blood vessels, thrombosis and anaesthetic complications. Laparoscopy or open surgery may be needed to complete the procedure. Conventional vaginal surgery, robotics and non-surgical options are also considered when appropriate.
Situations requiring particular assessment
- Significant pelvic adhesions or suspected obliteration of the pouch of Douglas.
- Deep endometriosis, previous rectal surgery or pelvic radiotherapy.
- Limited vaginal access, a large uterus or complex anatomy.
- Active genital or pelvic infection, suspected cancer outside a selected oncological indication, or anaesthetic limitations.
In cancer care, effective treatment comes first.
Sentinel lymph node assessment through vNOTES has been described in clinical series. Technical feasibility alone does not establish equivalent long-term cancer outcomes. Selection requires assessment of histology, molecular risk, disease extent and staging by a specialist multidisciplinary team; another surgical route may be required. [1, 2, 4]
05 / YOUR SURGEONDr. Rubèn
Dr. Rubèn
Baltà i Arandes
Medical registration 070709574 · COMIB
View hospital profile ↗Mayo Clinic · PhoenixIEO · MilanoQuirónsalud · Palma
A gynaecological surgeon with a particular focus on minimally invasive, vaginal and vNOTES surgery in Palma de Mallorca. He has helped introduce this approach in the Balearic Islands, with experience documented in the media and his hospital profile.
International training placements at Mayo Clinic in Phoenix and the European Institute of Oncology in Milan. Selecting an approach starts with listening to the patient and considering all alternatives.
His professional website identifies him as the most experienced vNOTES specialist in the Balearic Islands. This is a statement of his practice, not an independent comparative registry. Source: Dr. Baltà’s professional website
06 / LOCAL AND INTERNATIONAL PATIENTSFrom our first conversation
01 02 03 04
From our first conversation
to your recovery.
Get in touch
Request contact or book a private appointment on Doctoralia. Let us know if you will be travelling to Mallorca.
Assessment
We review your case and alternatives, agree on necessary tests and prepare an individual quotation.
Planning
Surgery takes place at Palmaplanas. Confirm dates, your stay and language support with the team before travelling.
Ongoing care
You receive discharge advice, review appointments and a follow-up plan for after your return home.
Insurance and private surgery
Patients with Spanish health insurance can access the hospital’s usual channels, subject to policy and authorisation. vNOTES surgery is usually offered privately with an individual quotation. Hospital cover does not automatically include every professional fee or the technique. Doctoralia appointments are private consultations.
CLEAR ANSWERS
Frequently asked questions
How long will I stay in hospital?
Selected patients may leave the same day or the following day. Discharge depends on the operation, clinical recovery and support at home.
When can I return to work, exercise or sex?
This depends on the procedure and the activity. Walking is usually resumed early; strenuous activity, sport and vaginal penetration require the team’s approval after healing is assessed.
Does a hysterectomy cause menopause?
Not necessarily. Surgical menopause occurs when both ovaries are removed before natural menopause. After removal of the uterus, periods and the ability to carry a pregnancy end, even when the ovaries are preserved.
Can I travel from another country?
Yes, we can assess your case before you arrange travel. Return dates, fitness to fly and follow-up are individual decisions. This website is available in three languages; please check availability of German interpretation.
How do I request a quotation?
Email the address below to arrange an assessment. Once your case is reviewed, the quotation sets out the proposed treatment and its cost components. There is no single price for all operations.
Patients travelling to Mallorca
Tell us your country of residence, preferred language and approximate dates. Before travelling, request an individual assessment and confirm appointment availability.
SCIENCE AND TRANSPARENCYEvidence,
Evidence,
within reach.
Selected verified publications, including recent research and foundational studies. Evidence is stronger for benign surgery than for some oncological applications.
Selection checked on 21 September 2026. This is not an exhaustive systematic review.
01 / 2026 · Journal of Gynecology Obstetrics and Human Reproduction · Gaillard et al.
vNOTES sentinel lymph node biopsy and hysterectomy for endometrial cancer staging: perioperative outcomes from a consecutive series ↗
Recent publication on perioperative outcomes. Reference located in PubMed and the journal; full text not assessed.
02 / 2025 / 2026 · Medicina · Can et al.Does Retroperitoneal vNOTES Sentinel Lymph Node Mapping Represent a Feasible Staging Option in Presumed Early-Stage Endometrial Cancer? ↗
Retrospective cohort of 98 patients; bilateral detection 87.8%. Short follow-up and no sensitivity validation: does not establish oncological equivalence.
03 / 2025 · Scientific Reports · Halisçelik et al.Comparison of conventional laparoscopic hysterectomy and vNOTES hysterectomy in previous pelvic surgery: a retrospective study ↗
Retrospective comparison of 100 patients with previous pelvic surgery. Favourable perioperative findings, limited by selection.
04 / 2024 · AOGS · Baekelandt et al.vNOTES retroperitoneal sentinel lymph node dissection for endometrial cancer staging: First multicenter, prospective case series ↗
A prospective multicentre series evaluating the feasibility of retroperitoneal sentinel node access.
05 / 2024 · JMIG · Morganstein et al.vNOTES versus Laparoscopic Uterosacral Ligament Suspension ↗
Comparison of uterosacral suspension: initial outcomes must be interpreted with adjustments and study limitations.
06 / 2021 · EJOG · Baekelandt & KapurubandaraBenign Gynaecological procedures by vNOTES: Complication data from a series of 1000 patients ↗
A series of 1,000 benign procedures documenting complications and the importance of surgical experience.
07 / 2023 · JSLS · Lerner et al.Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution ↗
A clinical review of the technique, patient selection, benefits and challenges.
YOUR NEXT STEP
Let’s discuss your case.
A personal assessment to understand your needs and explore the options available to you.
Use this form to request contact. Do not include medical records or sensitive health information.