Intraoperative Conversions in Minimally Invasive Colorectal Surgery
Minimally invasive colon and rectal surgery has evolved in parallel with case complexity, and while advances in technology mitigate some degrees of complexity, intraoperative conversion to a “more invasive” surgery is sometimes necessary. A misconception has arisen that deviation from the initially planned minimally invasive approach should be viewed with a negative light. Intraoperative conversion, however, is an efficacious adjunct in the surgeon’s armamentarium that provides added benefit to the patient when used judiciously. This manuscript focuses on the incidence of intraoperative conversion, optimizing a minimally invasive approach to decrease the incidence of conversion, identifying when conversion should be considered, and outlining techniques to maximize patient benefit when conversion is performed.
KeywordsSingle-incision laparoscopy Intraoperative conversion Multi-port laparoscopy Adhesions Bleeding Visualization
Dr. Skancke has no conflicts of interest or financial ties to disclose.
Dr. Obias is a consultant for Intuitive Surgical, Inc.
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- 2.Turrado-Rodriguez V, Soler E, Bollo J, et al. Are there differences between right and left colectomies when performed by laparoscopy? Surg Endosc. 2015;3:1413–8.Google Scholar
- 8.Scott C. The SAGES manual. The Society of American Gastrointestinal and Endoscopic Surgeons. 2006;2:46–58.Google Scholar
- 25.Bhama AR, Wafa AM, Ferraro J, Collins SD, Mullard AJ, Vandewarker JF, Krapohl G, Byrn JC, Cleary RK. Comparison of risk factors for unplanned conversion from laparoscopic and robotic to open colorectal surgery using the michigan surgical quality collaborative (MSQC) database. J Gastrointest Surg. 2016;1–8.Google Scholar
- 27.Podda M, Saba A, Porru F, et al. Systematic review with meta-analysis of studies comparing single-incision laparoscopic colectomy and multiport laparoscopic colectomy. Surg Endosc. 2016;23:1–24.Google Scholar
- 29.Jung KU, Yun SH, Cho YB, et al. Single incision and reduced port laparoscopy low anterior resection for rectal cancer: initial experience in 96 cases. ANZ J Surg. 2014;18:1–5.Google Scholar
- 35.Holder J, Mariscovetere P, Holubar S. Minimally invasive surgery for inflammatory bowel disease. Inflamm Bowel Dis. 2015;21:1443–58.Google Scholar