@article{article_1702426, title={Risk factors and outcomes of conversion to laparotomy of total laparoscopic hysterectomy: A single center experience}, journal={Ege Tıp Dergisi}, volume={64}, pages={665–673}, year={2025}, DOI={10.19161/etd.1702426}, url={https://izlik.org/JA63ZG97YK}, author={Yenigül, Nefise Nazlı and Aksan, Alperen and Karaşin, Süleyman Serkan and Oğuz, Seren and Karadavut, Sümeyye}, keywords={Laparoscopy, Laparotomy, Hysterectomy, Surgical Complications, Risk Factors}, abstract={Aim: This study aimed to analyze the risk factors and outcomes associated with conversion of total laparoscopic hysterectomy (TLH) to laparotomy in patients undergoing surgery for benign gynecologic conditions. Materials and Methods: A retrospective analysis was conducted of 160 women aged 35 to 70 years who underwent TLH or a procedure that started laparoscopically but required conversion to laparotomy between May 2016 and August 2021. Patients with suspected malignancy, previous oncologic procedures or incomplete data were excluded. Data collected included demographics, surgical indications, surgeon experience, intraoperative complications, and outcomes such as hospitalization, blood transfusion requirements, and intensive care unit (ICU) admission. Statistical analyses were performed to identify significant risk factors for conversion. Results: Of the 160 patients, 81 (50.6%) completed surgery laparoscopically, while 79 (49.4%) required conversion to laparotomy. The main reasons for conversion were adhesions (41.8%) and a large uterus (27.8%). Conversion cases had significantly longer hospital stays (p = 0.012), a higher rate of blood transfusion (p = 0.006) and a higher need for ICU admission (p = 0.011). Surgeon experience was not a statistically significant factor for conversion rates (p = 0.198), although experienced surgeons encountered more cases with the large uterus. Conclusion: Conversion from TLH to laparotomy is associated with increased morbidity, including longer hospital stays and higher transfusion rates. Adhesions and large uterine size were identified as major risk factors. Preoperative assessment and careful planning may reduce the need for conversion and improve patient outcomes.}, number={4}