Conversion Rate for Robotic-Assisted Gynecologic Cancer Surgery

Our objective was to identify the rate of and reasons for conversion from robotic-assisted surgery to laparotomy for patients with gynecologic cancers. A retrospective analysis was conducted of all consecutive robotic surgeries for gynecologic cancers performed at a tertiary cancer center between December 2007 and December 2022. Data were stratified based on cancer type (endometrial, ovarian, cervical, and "other") and body mass index (BMI). Reasons for conversion were categorized as specimen removal, anesthesia-related, organ or vessel injury, advanced metastatic disease, and equipment malfunction. The conversion rate was 2.4% (55/2,328) overall and 0.5% for endometrial cancer after excluding mini-laparotomies performed solely to remove large specimens. The predominant reason for conversion in ovarian cancer was disease invasion into surrounding structures not amenable to robotic resection. No association was found between conversion rates and BMI or age.