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Conversion from robotic surgery to laparotomy: a case-control study evaluating risk factors for conversion.

Nate Jones1, Nicole D Fleming2, Alpa M Nick2

  • 1Department of Obstetrics and Gynecology, Mountain Area Health Education Center, Asheville, NC 28805, USA.

Gynecologic Oncology
|June 18, 2014
PubMed
Summary

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Robotic gynecologic surgery conversion to laparotomy occurred in 8.7% of cases. Increased body mass index (BMI) and non-White race are key risk factors for conversion during robotic surgery.

Area of Science:

  • Minimally Invasive Surgery
  • Gynecologic Oncology
  • Surgical Technology

Background:

  • Robotic surgery offers potential benefits in gynecologic procedures.
  • Conversion to laparotomy remains a possibility in complex cases.
  • Identifying predictors of conversion is crucial for patient safety and surgical planning.

Purpose of the Study:

  • To identify preoperative and intraoperative risk factors associated with conversion from robotic surgery to laparotomy in gynecologic procedures.
  • To analyze the incidence and reasons for conversion in a large cohort of robotic gynecologic surgeries.

Main Methods:

  • Retrospective review of 459 consecutive robotic gynecologic surgery cases.
  • Comparison of cases converted to laparotomy versus those completed robotically.
Keywords:
ConversionMinimally invasive surgeryRobotic surgery

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  • Univariate and multivariate analyses to determine significant risk factors.

    • Main Results:

    • 8.7% of cases required conversion to laparotomy.
    • Significant risk factors for conversion included non-White race, higher body mass index (BMI), and bowel injury.
    • Poor visualization and inability to tolerate Trendelenburg position were common reasons for conversion.

    Conclusions:

    • Conversion to laparotomy is an infrequent but significant event in robotic gynecologic surgery.
    • Preoperative identification of patients with higher BMI and non-White race may aid in surgical planning and risk assessment.
    • Further research into mitigating factors for conversion is warranted.