Objectives: The purpose of our study was to evaluate cases that required conversion to laparotomy and its predisposing factors. Design: This was a retrospective study. Methods: We examined the medical records of women who underwent laparoscopic myomectomy during the period 2000–2008. Results: Of 67 patients, 9 required conversion of laparoscopy to laparotomy (conversion rate of 13.4%). The median diameter of the dominant myoma in the conversion group (group I) was 9 cm (range 6–17 cm) and in the laparoscopic myomectomy group (group II was 7.4 cm [range 4–21 cm; p: 0.03, CI 0–4.5]). Group I had more intramural myoma (n = 8; 88.9%) than group II (n = 28, 48.3%; p < 0.03), and two thirds of patients in group I had had posterior intramural myoma. Preoperative gonadotropin-releasing hormone analog (GnRHa) was used by all patients in group I and by 67.2% of patients in group II. There was no difference in the blood loss between both groups. The weight of myomas in group I (387.1 ± 86.0 g) was higher than in group II (196.7 ± 33.9 g, p < 0.04). Conclusions: Factors related to conversion of laparoscopic myomectomy to laparotomy are posterior intramural location, the use of preoperative GnRHa, the diameter of the dominant myoma, and the weight of the myoma. (J GYNECOL SURG 26:115)
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