Risk factors and outcomes of conversion to open surgery in benign gynecological laparoscopies: a case-control study

To describe cases of conversion from gynecological laparoscopy to open surgery, assess risk factors for conversion and conversion outcomes. A retrospective case-control study SETTING: Tertiary referral hospital in Melbourne, Australia PATIENTS: Eighty-five cases of conversion from laparoscopy to laparotomy and 170 controls matched by age, surgical date and gynecological unit from 2006-2017. Demographic, clinical and surgical data was collected and compared between the study groups. Logistic regression was performed to identify preoperative and intraoperative risk factors for conversion. Rate of conversion during the study period was 0.7%. The most common indication for conversion was unexpected surgical complexity (67% of cases) which included severe adhesive disease, specimen size, severe pathology and inadequate views. Factors that were significantly associated with risk of conversion in multivariate analysis were previous pelvic inflammatory disease (aOR 5.16 (1.35-19.71 95% CI, p=.02), previous open surgery (aOR 3.62 (1.52-8.58) 95% CI, p