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Conversions in laparoscopic renal surgery: causes and outcomes
Bert S Ivey1, Steven M Lucas, Carl A Meyer
1Department of Urology, Indiana University, Indianapolis, Indiana 46202, USA.
Journal of Endourology
|June 16, 2011
Summary
Conversions in laparoscopic renal surgery are influenced by surgical indication, specimen size, and technique. These conversions lead to increased perioperative complications and longer hospital stays.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Laparoscopic renal surgery offers benefits but can require conversion to open procedures.
- Understanding conversion factors is crucial for optimizing patient outcomes.
Purpose of the Study:
- To examine the rates, causes, and outcomes of conversions in laparoscopic renal surgery.
- To identify factors influencing the need for conversion to open procedures.
Main Methods:
- A nine-year retrospective review of laparoscopic renal surgeries at a single institution.
- Analysis of intraoperative results, conversion rates, and postoperative complications.
Main Results:
- 41 of 394 laparoscopic renal surgeries (10.4%) were converted to open procedures.
- Common conversion reasons included lack of progress, difficult anatomy, tumor thrombus, and bleeding.
- Converted cases showed significantly higher blood loss, operative time, transfusion rates, hospital stay, and complication rates (P<0.05).
Conclusions:
- Surgical indication, specimen size, and surgical technique significantly impact conversion rates.
- Conversion to open surgery is associated with increased perioperative morbidity.
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