Factors associated with conversion in laparoscopic surgery in a low-resource setting: a single-center prospective...

Area of Science:

• Minimally Invasive Surgery
• Global Health
• Surgical Outcomes

Background:

• Laparoscopic surgery offers patient benefits but is underutilized in low- and middle-income countries.
• Conversion to open laparotomy involves complex surgeon, patient, and procedural factors.
• Identifying conversion predictors is vital for optimizing surgical care in resource-limited environments.

Purpose of the Study:

• To analyze factors associated with conversion from laparoscopic to open surgery in a low-resource setting.
• To identify specific risk factors contributing to conversion in this context.
• To inform strategies for reducing conversion rates and improving patient outcomes.

Main Methods:

• A single-center prospective study was conducted from May 2018 to October 2021.
• Data collected included patient demographics (age, BMI), intraoperative complications, equipment failures, and conversion rates.
• Statistical analysis identified risk factors associated with conversion to laparotomy.

Main Results:

• A total of 123 laparoscopic surgeries were performed, with an 8.9% conversion rate to laparotomy.
• Key risk factors for conversion included BMI > 25 kg/m² (OR 4.6), intraoperative complications (OR 12.6), and equipment malfunction (OR 9.4).
• Equipment malfunction occurred in 9.8% of cases, and surgical complications in 8.9%.

Conclusions:

• Overweight/obesity, intraoperative complications, and equipment failure are significant predictors of laparoscopic surgery conversion in low-resource settings.
• Understanding these factors is essential for effective surgical planning.
• Addressing these issues can help reduce postoperative morbidity and improve the application of laparoscopic surgery in resource-limited areas.