Open abdominopelvic surgeries are becoming less common, often linked to complications from conversions from minimally invasive techniques.

• Minimally invasive approaches dominate: 98% for appendectomy and cholecystectomy; 84% for low anterior resection.
• Conversions to open surgery lead to longer operative times: appendectomy takes 147% longer, cholecystectomy 116% longer compared to minimally invasive methods.

Surgeons should reconsider the valuation of open procedures due to their increased complexity and associated complications.

• Compared to minimally invasive surgery, straight-to-open appendectomy increases length of stay (IRR 2.92) and complications (OR 4.02).