Materials and Methods: We retrospectively reviewed the data of 164 patients who underwent BTL using the v-NOTES method at our clinic between January 1, 2021 and July 31, 2025. The demographic data of the patient, the operative time, intraoperative complications, conversion rates to conventional laparoscopy, the length of hospital stay and postoperative pain scores were analysed. The primary endpoints were the appearance of major intraoperative complications and the need to convert to laparoscopy.

Results: The mean age of the 164 patients included in the study was 38.4 ± 4.7 years. The mean operative time was 36.2 ± 8.5 minutes. The overall rate of intraoperative complications was 2.4% (4/164). No major vascular or visceral organ injuries were observed. Two patients (1.2%) required conversion to conventional laparoscopy due to dense pelvic adhesions. The median length of hospital stay was 1 day, and postoperative pain scores were very low. No complications such as surgical site infections or incisional hernias occurred, owing to the absence of abdominal incisions.

Conclusions: BTL performed with the v-NOTES technique is a safe and effective method, offering low complication rates, short operative times, minimal postoperative pain, rapid recovery, and excellent cosmetic outcomes. Except for cases with suspected adhesions that obliterate the Douglas pouch, it should be considered a strong alternative to traditional methods for suitable patients seeking permanent sterilisation.