Risk factors and surgical outcomes of conversion of minimally invasive surgery to open procedure

Abstract

Background: Majority of laparoscopic procedures can be performed on day-care surgery basis, unexpected conversion to open surgery requires overnight or longer admission in these patients and can have additional financial and psychological impact on the patient. The aim of our study is to study the risk factors associated with conversion and the surgical outcomes in patients who underwent conversion of minimally invasive surgery to open procedure.Methods: It was a prospective observational study. All the patients who were planned for minimally invasive surgery but had intraoperative conversion to open surgeries were included.Results: A total of 41 patients were recruited in the study. Mean age of the patients was 44.7 years. Male patients had more frequent conversion (24 patients, 58.5%). 11 patients (26.8%) had history of previous surgery. Most common cause of conversion to open procedure was dense intra operative adhesions (24 patients, 58.5%); followed by iatrogenic injury to surrounding visceral organs or uncontrolled bleeding (11 patients, 26.8%). The average recovery time (duration till return to work) was 12 days. As per Clavien-Dindo classification, 28 patients (68.29%) had grade I, 9 patients (21.95%) had grade II, 3 (7.31%) had grade III, and one patient (2.43%) had grade IV complication.Conclusions: History of previous surgery and presence of intraoperative adhesions were frequently present in patients who underwent conversion of minimally invasive procedure. These patients required long period for recovery from the surgery and had frequent minor surgical complications.