Saltwater swish during scarless hysterectomy may cut pain

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Surgical Indication: Scheduled for elective total hysterectomy for gynecological conditions * Deemed suitable candidates for the vNOTES (Vaginal Natural Orifice Transluminal Endoscopic Surgery) approach by a senior gynecologic surgeon. * American Society of Anesthesiologists (ASA) physical status classification I or III. * Uterine volume ≤14 weeks of gestation (or a sonographically estimated weight of ≤ 500 grams) to ensure a standardized vNOTES procedural duration * Ability to understand the study protocol and provide written informed consent, including the willingness to use the Visual Analogue Scale (VAS) for pain assessment. * Sufficient literacy and fluency in Turkish to accurately complete postoperative pain and recovery surveys Exclusion Criteria: * Chronic Pain Syndromes: Diagnosis of chronic pelvic pain, fibromyalgia, or any condition requiring long-term analgesic or opioid therapy, as these may distort postoperative Visual Analogue Scale (VAS) scores. * Extensive Adhesions: Known or suspected severe pelvic adhesions (Stage III or IV endometriosis) or a history of multiple major abdominal surgeries that might necessitate conversion to traditional laparoscopy or laparotomy. * Uterine Size: Uterine weight exceeding 500 grams or size greater than 14 weeks of gestation, potentially requiring morcellation or prolonged surgical time. * Anatomical Constraints: Severe vaginal stenosis or insufficient vaginal access that precludes the vNOTES approach. * Hypersensitivity: Known allergy or hypersensitivity to local anesthetics or medications used in the standardized postoperative pain protocol. * Psychiatric/Cognitive Disorders: Any condition that impairs the patient's ability to reliably report pain levels using the VAS or follow the study protocol.