Many patients choose laparoscopic surgery because it is “minimally invasive” and avoids the trauma of open surgery. However, in practice, some laparoscopic procedures may be converted to open surgery, so does this mean that the laparoscopic procedure has failed? What are the circumstances that would convert to open surgery?
Transfer to open ≠ treatment failure
In fact, laparoscopy can be performed safely and effectively in most patients who are eligible (indication). However, because of the inherent limitations of laparoscopic operation, the difficulty in managing severe bleeding and injury, and the as yet insufficient clinical evidence in the surgical treatment of advanced tumors, the surgeon may find intraoperative laparoscopic surgery unsuitable for continued laparoscopic treatment, at which point conversion to open surgery will be promptly made. It is important to understand that this conversion does not imply failure of the procedure and is a response to the choice of the best treatment modality for the patient.
What conditions will physicians consider for conversion to open surgery?
Doctors will usually consider conversion to open surgery when performing laparoscopic surgery for the following conditions:
- Laparoscopic exploration and intraoperative detection of tumor invasion of adjacent organs (stage T4b);
- Severe intra-abdominal adhesions on laparoscopic exploration and intraoperative findings;
- Patients with intraoperative difficulty tolerating pneumoperitoneum;
- Patients with intraoperative difficulty tolerating pneumoperitoneum
- Intraoperative uncontrollable bleeding or injury.
In summary, even if laparoscopic surgery is chosen to treat gastric cancer, patients should be fully aware of the possible changes that may occur during surgery and be prepared for the possibility of a conversion to open surgery. Patients should understand that conversion to open surgery does not mean treatment failure, but a more suitable treatment method for them. (Contributed by Hanyu Chen, Department of Gastrointestinal Oncology, The First Hospital of China Medical University)