title: Electrocautery-associated vascular injury during robotic-assisted surgery.
abstract: BACKGROUND
  The robotic surgical platform is increasingly used in gynecology and, similar to laparoscopy, it has risks of electrocautery-associated injury.
  
  
  METHODS
  We present three cases of injury caused by failures of the monopolar scissors' insulating sheath while coagulation and cutting currents were set at 35 W. In case 1, an external iliac vein injury required blood transfusion and emergent laparotomy. In case 2, a full-thickness external iliac artery injury was repaired robotically. In case 3, a partial-thickness external iliac artery injury also was repaired robotically.
  
  
  CONCLUSIONS
  Unintended electrosurgical arcs can occur from monopolar instruments. Insulation failure is a common finding in this type of injury. Surgeons should avoid excessive instrument collisions and should change the monopolar scissors' insulating sheath if there are any concerns of a defect in its integrity.
authors: From the Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, and the Division of Minimally Invasive Gynecologic and Robotic Surgery, Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, New York, New York.
authors: Beatrice
authors: B
authors: Cormier
authors: Farr
authors: F
authors: Nezhat
authors: Jason
authors: J
authors: Sternchos
authors: Yukio
authors: Y
authors: Sonoda
authors: Mario M
authors: MM
authors: Leitao
mesh_terms: D000328:Adult; D000368:Aged; D004564:Electrocoagulation / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods; D007083:Iliac Artery / Q000293:injuries*; D007084:Iliac Vein / Q000293:injuries*; D007813:Laparotomy; D008197:Lymph Node Excision / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D012371:Robotics; D058994:Salpingectomy / Q000295:instrumentation / Q000379:methods; D057772:Vascular System Injuries / Q000209:etiology* / Q000601:surgery