How Long is Too Long for Laparoscopic Procedure?

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When should a surgeon shift from laparoscopic techniques to open surgery? Skeptical Scalpel, a blog from an anonymous former chairman of surgery and residency program director, says don’t be afraid to shift mid-surgery if it’s in the best interest of the patient. 

“You got to know when to hold ‘em, know when to fold ‘em,” he says. Since the beginning of robotic surgery, many surgeons have been hesitant to abandon laparoscopy and move to open surgery in complicated cases.  

After 20 years of doing laparoscopic gallbladder surgeries, Skeptical Scalpel recommends that after 1 to 2 hours of no progress in laparoscopic surgery, shift to open surgery. What are your best practices around laparoscopic surgeries? Do you have protocols developed to address this issue?