Adnexal surgery is one of the most common surgeries performed in women. Minimally invasive methods are on the rise globally as they have been shown to decrease surgical morbidity compared with abdominal surgery. Adnexal surgery by vaginal natural orifice transluminal endoscopic surgery (vNOTES) is the latest innovation. It combines the vaginal approach and endoscopy via the vagina. Large pragmatic randomised controlled trials (RCTs) are lacking comparing outcomes after vNOTES and conventional laparoscopy.

A multicentre pragmatic RCT aiming to recruit 200 women aged 18 years and above undergoing adnexal surgery for benign disease or prophylactic reasons. Patients will be randomised to vNOTES or laparoscopy. Recruitment will start Q4 2025, and the study is estimated to end 2028.

The primary outcome is postoperative pain. Secondary outcomes are units of postoperative opioid and non-opioid analgesics used, perioperative complications, operation time, postoperative complications, readmission, conversion rate and the surgeon’s experience.

The national Swedish ethical board at the main centre, Helsingborg Hospital, Sweden, has given ethical agreement (dated 20 March 2025). Before including patients, all centres will require local or national ethical approval. The results of the study will be published in international peer-reviewed journals.

NCT06964594.

To explore the experience and impact of physical chronic illnesses in the lives of young people.

Qualitative study using semi-structured interviews.

Interviews were conducted between March 2023 and February 2024 either via video call (14) or face-to-face (19). Recruitment was done primarily through flyers in public spaces, specialists’ waiting rooms and research pages of chronic disease websites and supplemented through snowballing.

Young adults aged 19–29 years (n=33, mean age 23 years) who had lived with a physical chronic illness for 6 months or more. All participants lived in Australia.

Three key findings were identified: (i) chronic illness impacts the lives of young people in a particular way, as participants reported that their young age, and the youth of their peers, influenced their interactions with healthcare professionals, their access to support and their sense of isolation; (ii) participants struggled to come to terms with, and describe, the influence of their chronic illness on their overall life and lifestyle, particularly when outside of the ‘expected’ symptoms of disease; (iii) the lack of education and guidance about the wide range of impacts that chronic illness can have seemed to compound participants’ reported sense of guilt, self-blame and exhaustion.

This study illustrates how youth is a critical contextual element when considering different population groups’ challenges in managing chronic illnesses. It finds that young people may internalise blame for these challenges despite the fact they are structural issues. Understanding this context will aid the provision of better healthcare experiences and support programmes. Further research could help establish better expert and peer support models to help adults and young people better anticipate, understand and manage the wide-reaching impacts of chronic illness.