Thu, Jan 29, 2026 at 12:00 AM

Surgical procedure is game-changer for gynecological patients

vNotes technique means no visible scars, less pain, shorter time in hospital and quicker recovery.

When Kaleigh Gunter’s OB-Gyn recommended she have a hysterectomy last spring, she expected she would be off her feet and out of work for several weeks. With four children, that would not be easy but neither were the heavy menstrual cycles and pain she was enduring. She agreed to the procedure and was pleasantly surprised at how quickly she recovered.

“The surgery itself was a breeze,” Gunter recalled. “I was down a few days then I felt great. Recovery was a breeze. The whole thing was amazing.”

Her fast and easy recovery time is attributed to a relatively new procedure known as vNOTES – Vaginal Natural Orifice Transluminal Endoscopic Surgery. vNOTES is an advanced, minimally invasive surgical approach in gynecology that uses the vagina as the natural entry point for endoscopic procedures. Benefits include no external scars, less pain, quicker recovery and shorter hospital stays compared to traditional laparoscopic or open surgery for procedures like hysterectomies, ovary removal or fibroid removal. Gunter’s physician, Dr. Megan Zeien of Medical Centers OB/GYN at Marshall North, is proud to offer the option to her patients.

“It’s very exciting for Marshall County,” she said. “We’re using a natural orifice for surgery leading to faster healing. This one is specific for the vaginal opening using laparoscopy. We’re going through less tissue to get to the area we need to access. We’re using laparoscopic skills through a natural orifice.”

Dr. Zeien has been delivering babies and performing surgeries for 15 years at Marshall North. When she heard that vNOTES makes surgeries easier on patients, she became interested in training. She has now performed more than 20 operations using vNOTES.

“Across the board, patients are healing so much better and so much faster,” said Dr. Zeien. “Whether we’re taking out tubes or doing a hysterectomy, it’s all done through the vagina. There are no scars on the abdomen at all.”

vNOTES enhances visualization and control by incorporating specialized tools, allowing complex surgeries, even in cases with previous C-sections or obesity, to be performed through a vaginal route. Whether a woman is a good candidate for vNOTES is decided by the patient and her doctor. The procedure is same-day surgery with most patients able to leave the hospital within four hours.

Dr. Zeien’s medical partner, Dr. Holly Kiper, DO, joined the practice in September 2025. She started using vNOTES during her third year of residency.

“When Dr. Zeien decided she was going to get certified in it, I went ahead and jumped on the train because it’s definitely a technique that’s been great for patients,” Dr. Kiper said.

She expects about half of her surgeries will be done with vNOTES and half as robotic surgeries, which she performs at Marshall South, depending on what the patient needs.

“vNOTES is a great tool for the right case,” Dr. Kiper said. “I’m not going to make incisions in somebody’s belly if I can go in through the vagina and do it laparoscopically with one incision. It’s better for all parties. It’s better for the patient under anesthesia, being able to leave and not stay two nights in the hospital from a big C-section incision. It’s great.”

Dr. Kiper is from Satsuma, a small town just outside of Mobile. She earned her undergraduate degree at the University of South Alabama. After moving to Dothan for medical school at the Alabama College of Osteopathic Medicine, she had the opportunity to do her clinical rotations in Guntersville — and fell in love with the community.

Dr. Zeien and Dr. Kiper, along with a surgeon at Huntsville Hospital’s Women and Children’s, are the only ones in North Alabama using vNOTES. Dr. Zeien hopes to accommodate more patients for surgery consults so they have access to vNOTES.

“It’s something I’m pretty excited about.”

On the day of her hysterectomy at Marshall North day surgery, Gunter got back to her home in Albertville around 3 pm. She had some discomfort, soreness and pressure but experienced no pain in the following days. Even better, she had no visible cuts or stitches.

“Because I didn’t have surgery on my stomach to get to my uterus, I think that’s why my recovery was so easy,” she said. “I would recommend it to anybody.”

At her 2-week post-op appointment, Gunter told Dr. Zeien how well she was doing. She was cleared to lift her children, clean house and resume normal activities. She went back to work at Asbury Elementary 10 days after the procedure.

“Dr. Zeien said my body would tell me if I had overdone it and so far my body has not.”

To learn more about services provided by Medical Centers OB/GYN North or to make an appointment, please call (256) 571-8470.