Laparoscopic conversion rate for uterine cancer surgical staging

Objective: To estimate the conversion rate of attempted laparoscopic staging for primary endometrial adenocarcinoma. Methods: Two hundred thirty-five consecutive patients with primary endometrial adenocarcinoma underwent attempted laparoscopic staging regardless of age, body mass index (BMI, calculated as weight (kg)/[height (m)]), uterine size, and prior surgery. No patients were excluded. Results: Mean BMI was 39 (range, 22-77), and 85 patients (36%) had a BMI higher than 40 kg/m. Mean blood loss was 162 mL (range, 25-1850 mL), mean operating room time was 2 hours (range, 1-4 hours 20 minutes), and mean hospital stay was 1 day (range, 1-4 days). There were six conversions (3%) to laparotomy or vaginal hysterectomy, all occurring in patients with a BMI higher than 40; mean BMI of conversions was 66 (range, 55-77). Conclusion: Of 235 consecutive cases of attempted laparoscopic staging for primary endometrial adenocarcinoma, conversion to laparotomy or vaginal hysterectomy occurred in 3% of the total patients and 7% in patients with a BMI of 40 or higher.