Analysis of the causes of laparoscopic converted to open surgery in urology

Objective To analyze the causes of laparoscopic converted to open surgery in urology. Methods The study included 165 patients undergoing urologic laparoscopic surgery in our institute. A total of 26 patients(16%) converted to open surgery during the procedure. Results The primary causes of conversion to open surgery were missed target in 8 patients, discontent of intraperitoneal or retroperitoneal insufflation in 5, adherence in 5,hemorrhage in 4,injury of organ in 2 and malfunction of instruments in 2 cases. Different laparoscopic procedures had different proportion of conversion to open surgery.In laparoscopic adrenalectomy 42% of patients converted to open surgery (8/19), 25% in nephrectomy(2/8), 18% in renal cyst excision(11/61), 17% in pelvic lymphadenectomy of prostatic cancer(1/6),3% in varico- celectomy (2/60) and 19% in orchiectomy(2/11). Conclusions Selection of proper indication and laparoscopic approach, improvement of skill and adequate instruments are essential for urologic laparoscopy.