Factors Leading to Conversion from Laparoscopy to Open Surgery in Partial Nephrectomy: a Case Series and Literature Review

Minimally invasive surgery offers significant benefits for partial nephrectomy. Intraoperative incidents and postoperative complications lead to conversion to open surgery and increase perioperative morbidity and mortality. Understanding the factors that contribute to the occurrence of complications is important for reducing the perioperative risk. Between 2022 and 2024, we prospectively observed intraoperative complications in cases of partial nephrectomy performed laparoscopically in the Urology Department of 'Professor Dr. Theodor Burghele' Clinical Hospital, Bucharest, Romania. We report seven cases in which laparoscopic partial nephrectomy was converted to an open approach, requiring prompt management. The most common complication leading to conversion was the presence of adhesions, which made dissection of the planes difficult, followed by intraoperative bleeding, which hindered optimal visualization. Laparoscopic partial nephrectomy is challenging and its management must be individualized. Conversion during laparoscopic renal procedures is usually rare; however, a significant event is influenced by the complexity of the procedure and patient characteristics.