title: Malfunction of the da Vinci robotic system in urology.
abstract: OBJECTIVE
  To analyze the incidence of malfunction of the da Vinci robotic system in a single center and to provide potential solutions.
  
  
  METHODS
  A total of 400 patients underwent da Vinci robotic urological surgery at Taichung Veterans General Hospital in Taichung, Taiwan, from December 2005 to April 2011. Episodes of malfunction of the robotic system were analyzed by period of operation, type of procedure, type of malfunction and management of the event.
  
  
  RESULTS
  Overall, 14 cases of malfunction occurred (3.5% of the entire series). Among them, five (1.25%) occurred before the surgery and nine (2.25%) intraoperatively. Operative procedures included radical prostatectomy, bilateral pelvic lymph node dissection, dismembered pyeloplasty, partial nephrectomy, nephroureterectomy, and radical and partial cystectomies. Areas of malfunctions included the robotic arm system and joint (11/14), optical system (1/14), power system and connector (1/14), endoscopic instrument (1/14), and software (1/14). In 10 cases, the failure was recoverable, whereas in four cases there was a critical failure, requiring a conversion to standard laparoscopy in three of them, and the rescheduling of the surgery in one case.
  
  
  CONCLUSIONS
  The da Vinci robotic system is extremely reliable for use in urology. Malfunction is rare and the risk of critical failure is very low. Managing mechanical failure before or during the surgery is the key to maintaining the safety of patients undergoing robotic surgical procedures.
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Cheng-Che
authors.initials: CC
authors.lastname: Chen
authors.forename: Yen-Chuan
authors.initials: YC
authors.lastname: Ou
authors.forename: Cheng-Kuang
authors.initials: CK
authors.lastname: Yang
authors.forename: Kun-Yuan
authors.initials: KY
authors.lastname: Chiu
authors.forename: Shian-Shiang
authors.initials: SS
authors.lastname: Wang
authors.forename: Chung-Kuang
authors.initials: CK
authors.lastname: Su
authors.forename: Hao-Chung
authors.initials: HC
authors.lastname: Ho
authors.forename: Chen-Li
authors.initials: CL
authors.lastname: Cheng
authors.forename: Chuan-Shu
authors.initials: CS
authors.lastname: Chen
authors.forename: Jian-Ri
authors.initials: JR
authors.lastname: Lee
authors.forename: Wen-Min
authors.initials: WM
authors.lastname: Chen
mesh_terms: D000368:Aged; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics / Q000706:statistics & numerical data*; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data*; D055815:Young Adult