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Historically, one of the most common complications encountered during a laparoscopic myomectomy was the need to convert to laparotomy.
Eighteen patients (66.6%) had unresectable disease identified at laparoscopy and fourteen were able to convert to laparotomy palliative surgery while for the others laparoscopy spared an unnecessary laparotomy.
This setup requires flexibility of the operation schedule while one needs to be prepared to convert to laparotomy and an extensive resection when SL proves negative; Application of SL as a protocol performed by dedicated (staff) surgeons experienced in laparoscopic procedures.
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Of these, two procedures were converted to laparotomy.
Emergency laparoscopic surgery was planned, but due to extensive intraabdominal adhesions, laparoscopy was converted to laparotomy.
Only 1 patient who had laparoscopy needed to be converted to laparotomy.
One patient from the electrosurgery group was converted to laparotomy due to injury to the epigastric vessels.
The diagnostic laparoscopy procedure was converted to laparotomy in three cases (12.5%) owing to the size of the enlarged ovaries.
Eleven BSOs were converted to laparotomy due to intra-abdominal adhesions and/or otherwise not being able to resect the ovaries and tubes completely.
Laparoscopic surgeries were successfully carried out for all patients, without any case converted to laparotomy during the operation nor the death related to surgery.
In addition, Schäfer et al. have reported that advanced age and a high serum CRP level may be predictive factors for the surgical procedures that are used in patients undergoing laparotomy and patients who were converted to laparotomy [ 32].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com