FACTORS LEADING TO CONVERSION OF LAPAROSCOPIC TO OPEN SURGERY IN PATIENTS PRESENTING WITH ACUTE ABDOMEN daniyal_zahoor2009@live.com

 

FACTORS LEADING TO CONVERSION OF LAPAROSCOPIC TO OPEN SURGERY IN PATIENTS PRESENTING WITH ACUTE ABDOMEN

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Pakistan

Oral or Poster

Laparoscopic surgery has become a preferred approach for managing acute abdomen due to its minimally invasive nature. However, certain intraoperative challenges may necessitate conversion to open surgery. This study aims to assess the frequency and identify the key reasons for such conversions

This prospective, cross-sectional study was conducted at the Department of Surgery,Jinnah Postgraduate Medical Center, Karachi, over an 18-month period from January 2021 to July 2022. A total of 200 patients presenting with acute abdomen were enrolled through non-probability convenience sampling. Patients requiring intraoperative conversion due to complexity or complications were noted. Data were analyzed using SPSS.

Out of 200 patients, the majority were males (67.5%) with a mean age of 35 years. Most patients came from rural areas (62%). Acute appendicitis was the most common diagnosis, accounting for nearly three-quarters of all cases. Conversion from laparoscopy to open surgery was required in 11% of patients. The leading causes of conversion included dense adhesions (26%), uncontrolled bleeding (34%), and severe inflammation obscuring anatomical landmarks (35%). Previous abdominal surgeries and delayed presentation of perforated cases also contributed to conversion in select cases.

Approximately one in every ten laparoscopic procedures for acute abdomen required conversion to open surgery. Common contributing factors included extensive adhesions, severe local inflammation, intraoperative bleeding, and anatomical difficulty. Timely presentation and careful patient selection may help reduce conversion rates and improve surgical outcomes.