title: Robotic equipment malfunction during robotic prostatectomy: a multi-institutional study.
abstract: 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%.
authors.affiliation: Department of Urology and Center for Robotic and Computer Assisted Surgery, The Ohio State University Medical Center, Columbus, Ohio 43210, USA.
authors.forename: Hugh J
authors.initials: HJ
authors.lastname: Lavery
authors.forename: Rahul
authors.initials: R
authors.lastname: Thaly
authors.forename: David
authors.initials: D
authors.lastname: Albala
authors.forename: Thomas
authors.initials: T
authors.lastname: Ahlering
authors.forename: Arieh
authors.initials: A
authors.lastname: Shalhav
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.forename: Randy
authors.initials: R
authors.lastname: Fagin
authors.forename: Peter
authors.initials: P
authors.lastname: Wiklund
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Costello
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tewari
authors.forename: Geoff
authors.initials: G
authors.lastname: Coughlin
authors.forename: Vipul R
authors.initials: VR
authors.lastname: Patel
mesh_terms: D004868:Equipment Failure; D006761:Hospitals; D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000295:instrumentation*; D012371:Robotics / Q000295:instrumentation*; D011795:Surveys and Questionnaires