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Conversion Rate for Robotic-Assisted Gynecologic Cancer Surgery.
Peter Scalia1, Gabriel Levin, Tomer Bar Noy
1Division of Gynecology Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Obstetrics and Gynecology
|July 24, 2025
Summary
The overall conversion rate from robotic surgery to laparotomy for gynecologic cancers was 2.4%. The main reasons for conversion varied by cancer type, with disease invasion being key for ovarian cancer.
Area of Science:
- Gynecologic Oncology
- Minimally Invasive Surgery
- Surgical Technology
Background:
- Robotic-assisted surgery (RAS) is increasingly used for gynecologic cancers.
- Understanding conversion rates from RAS to laparotomy is crucial for patient safety and surgical planning.
Purpose of the Study:
- To determine the rate of conversion from robotic surgery to open laparotomy in patients with gynecologic cancers.
- To identify the primary reasons for these conversions.
Main Methods:
- Retrospective analysis of consecutive robotic surgeries for gynecologic cancers (December 2007-December 2022).
- Data stratified by cancer type (endometrial, ovarian, cervical) and body mass index (BMI).
- Reasons for conversion categorized (specimen removal, anesthesia, injury, metastasis, equipment).
Main Results:
- Overall conversion rate was 2.4% (55/2,328).
- Endometrial cancer conversion rate was 0.5% (excluding mini-laparotomies for specimen removal).
- Predominant reason for ovarian cancer conversion: disease invasion into surrounding structures; no association found with BMI or age.
Conclusions:
- Robotic surgery demonstrates a low overall conversion rate for gynecologic cancers.
- Specific reasons for conversion, such as advanced disease in ovarian cancer, necessitate careful pre-operative assessment.
- RAS is a viable option for gynecologic cancer surgery with manageable conversion rates.
