Skip to main content

Abstract

Converting from one approach to another always comes as a tough pill to swallow. It is so for the surgeon, whose plans have to change while accepting that the initially preferred strategy has failed. It also poses challenges for the operating room (OR) staff who must rapidly modify the work setting in order to create the best possible environment to complete the case. There are challenges for the hospital administration as well, since there is evidence that conversion increases the intraoperative and postoperative costs of the surgical process. Most importantly, for the patient, as in the vast majority of cases, converting from a minimally invasive approach to open surgery leads to worst short- and long-term outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cleary RK, Mullard AJ, Ferraro J, Regenbogen SE. The cost of conversion in robotic and laparoscopic colorectal surgery. Surg Endosc. 2018;32(3):1515–24. https://doi.org/10.1007/s00464-017-5839-8. Epub 2017 Sep 15.

    Article  PubMed  Google Scholar 

  2. de Neree Tot Babberich MPM, van Groningen JT, Dekker E, Wiggers T, Wouters MWJM, Bemelman WA, Tanis PJ, Dutch Surgical Colorectal Audit. Laparoscopic conversion in colorectal cancer surgery; is there any improvement over time at a population level? Surg Endosc. 2018;32(7):3234–46.

    Article  Google Scholar 

  3. https://dictionary.cambridge.org/dictionary/english/conversion. Last time checked 6/3/18.

  4. Bhama AR, Charlton ME, Schmitt MB, Cromwell JW, Byrn JC. Factors associated with conversion from laparoscopic to open colectomy using the National Surgical Quality Improvement Program (NSQIP) database. Colorect Dis. 2015;17:257–64.

    Article  CAS  Google Scholar 

  5. Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MHGM, de Lange-de Klerk ESM, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372:1324–32.

    Article  CAS  Google Scholar 

  6. Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA. 2017;318(16):1569–80.

    Article  Google Scholar 

  7. Yang C, Wexner SD, Safar B, Jobanputra S, Jin H, Li VK, Nogueras JJ, Weiss EG, Sands DR. Conversion in laparoscopic surgery: does intraoperative complication influence outcome? Surg Endosc. 2009;23(11):2454–8. https://doi.org/10.1007/s00464-009-0414-6. Epub 2009 Mar 25.

    Article  PubMed  Google Scholar 

  8. Wexner SD. Definitions of conversion—reactive vs preemptive. Presented at the 8th Annual International Colorectal Disease Symposium, hosted by the Cleveland Clinic Florida, Fort Lauderdale, FL in February. 1997.

    Google Scholar 

  9. Penna M, Hompes R, Arnold S, Wynn G, Austin R, Warusavitarne J, Moran B, Hanna GB, Mortensen NJ, Tekkis PP, TaTME Registry Collaborative. Transanal Total Mesorectal excision: international registry results of the first 720 cases. Ann Surg. 2017 Jul;266(1):111–7.

    Article  Google Scholar 

  10. Cooper MA, Ibrahim A, Lyu H, Makary MA. Underreporting of robotic surgery complications. J Healthc Qual. 2015;37(2):133–8. https://doi.org/10.1111/jhq.12036.

    Article  PubMed  Google Scholar 

  11. Penna M, Hompes R, Arnold S, Wynn G, Austin R, Warusavitarne J, Moran B, Hanna GB, Mortensen NJ, Tekkis PP, TaTME Registry Collaborative. Transanal Total Mesorectal excision: international registry results of the first 720 cases. Ann Surg. 2017;266(1):111–7.

    Article  Google Scholar 

  12. Buess G, Theiss R, Günther M, Hutterer F, Pichlmaier H. Endoscopic surgery in the rectum. Endoscopy. 1985;17(1):31–5.

    Article  CAS  Google Scholar 

  13. Christoforidis D, Cho HM, Dixon MR, Mellgren AF, Madoff RD, Finne CO. Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer. Ann Surg. 2009;249(5):776–82.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Montroni, I., Spinelli, A. (2019). Intraoperative Decision-Making: Converting to taTME, When and for Whom?. In: Atallah, S. (eds) Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME). Springer, Cham. https://doi.org/10.1007/978-3-030-11572-2_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-11572-2_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-11571-5

  • Online ISBN: 978-3-030-11572-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics