Converting minimally invasive liver surgery may significantly impact patient outcomes based on urgency and approach.

• Among 10,548 cases, 6.8% required conversion, with emergency conversions linked to increased blood loss, transfusions, and severe morbidity.
• Elective conversions showed a safer profile, while robotic conversion had a concerning 7.7% mortality rate.

Understanding these factors is vital for surgical decision-making and patient selection.

• Risk factors include bilobar disease for robotic conversions and cirrhosis or prior liver surgery for laparoscopic conversions.