Transvaginal natural orifice transluminal endoscopic surgery (vNOTES), as a minimally invasive surgery technique, applies CO2 for creating pneumoperitoneum, and uses a closed system to through smoke evacuation from a dedicated outlet or port. It has the potential to generate aerosol in the operation room, which can lead to an increased risk of transmission of SARS-CoV-2. This technical note introduces a new technique of gasless pure vNOTES to hysterectomy using silicone face mask as a modified vNOTES port.
