Objective:To investigate the efficacy and perioperative problems of the fourth-generation Da Vinci Xi robot-assisted vaginal natural orifice transluminal endoscopic surgery(vNOTES)in gyne-cology.Methods:The clinical data and auxiliary examination results of 10 cases of robot-assisted vNOTES(R-vNOTES)in the Department of Gynecology of Zhongnan Hospital of Wuhan University were retrospectively analyzed.The operation time,estimated blood loss,length of hospital stay,and perioperative complications were evaluated.Results:After R-vNOTES treatment,patients recovered smoothly without bleeding,urine leakage,infection,or other complications.Conclusion:R-vNOTES has certain safety and feasibility for gynecological benign and malignant diseases,but it still needs to be further confirmed by large-scale prospective studies.