Robotic equipment malfunction during robotic prostatectomy: a multi-institutional study.
OBJECTIVE
Robotic-assisted laparoscopic prostatectomy (RALP) is growing in popularity as a treatment option for prostate cancer. As a new technology, little is known regarding the reliability of the da Vinci robotic system. Intraoperative robotic equipment malfunction may force the surgeon to convert the procedure to an open or pure laparoscopic procedure, or possibly even abort the procedure. We report the first large-scale, multi-institutional review of robotic equipment malfunction.


METHODS
A questionnaire was designed to evaluate the rate of perioperative robotic malfunction during RALP. High-volume, experienced surgeons were asked to complete this evaluation based on the analysis of their data. Questions included the overall number of RALPs performed, the number of equipment malfunctions, the number of procedures that had to be converted or aborted, and the part of the robotic system that malfunctioned.


RESULTS
Eleven institutions participated in the study with a median surgeon volume of 700 cases, accounting for a total case volume of 8240. Critical failure occurred in 34 cases (0.4%) leading to the cancellation of 24 cases prior to the procedure, and the conversion to two laparoscopic and eight open procedures. The most common components of the robot to malfunction were the arms and optical system.


CONCLUSIONS
Critical robotic equipment malfunction is extremely rare in institutions that perform high volumes of RALPs, with a nonrecoverable malfunction rate of only 0.4%.
Lavery
Hugh J
HJ
Department of Urology and Center for Robotic and Computer Assisted Surgery, The Ohio State University Medical Center, Columbus, Ohio 43210, USA.
Thaly
Rahul
R
Albala
David
D
Ahlering
Thomas
T
Shalhav
Arieh
A
Lee
David
D
Fagin
Randy
R
Wiklund
Peter
P
Dasgupta
Prokar
P
Costello
Anthony J
AJ
Tewari
Ashutosh
A
Coughlin
Geoff
G
Patel
Vipul R
VR
D004868:Equipment Failure; D006761:Hospitals; D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000295:instrumentation*; D012371:Robotics / Q000295:instrumentation*; D011795:Surveys and Questionnaires