Open Conversion

In some cases, intraoperative conversion may be required. Our indications for intraoperative conversion are:

■ ■ Uncontrollable hemorrhage,

■ Obvious contiguous organ invasion that necessitates en-bloc resection, and

■ Failure to progress

Regarding failure to progress, we do not set an absolute time limit. As long as the procedure is proceeding safely, it is often better to finish the operation laparoscopically rather than have the patient incur the morbidity of an open operation superimposed on a long laparoscopic procedure.

We generally set a time limit of five hours for all laparoscopic procedures before conversion because in our experience, the risks of nerve compression increase significantly after this time.

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