Related Experiment Video
Updated: Jan 11, 2026
Robotic-assisted Lateral Pancreaticojejunostomy for Chronic Pancreatitis
Published on: September 5, 2025
The CONVERSION Study: Open Conversion Risk in Robotic vs Laparoscopic Surgery-A 20-Year Meta-analysis
Antonio Gangemi1,2, Amir Ebadinejad3, Anthony P Lisi1
1Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum Università of Bologna. Via Massarenti, 9 - 40138 Bologna, Italy.
Objective:
To compare the rate of conversion to open surgery (OC) between robotic-assisted surgery (RAS) and laparoscopy (LAP) across 15 abdominal procedures.
Background:
OC worsens outcomes and costs; a cross-disciplinary estimate of OC risk in RAS versus LAP across general surgery and subspecialties has been lacking.
Methods:
PRISMA-guided systematic review (PubMed, Web of Science, Scopus; 2000-2023). Primary endpoint: pooled random-effects odds ratio (OR) for OC (RAS vs LAP) with 95% CIs; heterogeneity quantified by I² and τ². Meta-regression tested age, BMI, and sex.
Results:
360 studies (14 RCTs, 36 prospective, 310 retrospective; 211,078 RAS and 1,358,201 LAP) from 30 countries met inclusion. RAS had lower pooled odds of OC than LAP across procedures and study types. Meta-regression showed no significant effect of age, BMI, or sex on OC. Heterogeneity was moderate-to-high overall and varied by procedure (full metrics and forest plots in SDC, http://links.lww.com/SLA/F670).
Conclusions:
Across diverse abdominal procedures, RAS is associated with lower OC risk. Findings support multi-specialty decision-making, while acknowledging heterogeneity, learning-curve effects, and procedure-specific evidence gaps.
