Robotic malfunction during live robotic urologic surgery: live surprise in a robotic surgery congress.

摘要

BACKGROUND: Robotic-assisted laparoscopic radical prostatectomy (RARP) has increasingly become a preferred treatment of choice. Since it is a device dependant surgery, robotic surgery may be a challenging procedure due to failure. METHODS: We report how we managed to complete successfully a case of RARP with laparoscopic approach in spite of right robotic arm failure during live surgery. RESULTS: A 56-year-old male patient diagnosed with localized prostate cancer (PCa) (Gleason score 3 + 3 = 6) with a serum prostate specific antigen (PSA) level of 7.6 ng/mL was elected for a live RARP case during the 1st Turkish National Robotic Surgery Congress in 2011. Following 120 minutes from starting the RARP procedure, the right robotic arm failed surprisingly with a "recoverable fault" message appeared on the screen. Pressing "recover fault" button did not work and the right arm operated for few seconds more but the fault repeated again. We replaced the robotic instruments, shut down and restarted the system again that were all useless. Finally, all of the arms were out of order and we were not able to use the robot anymore. Therefore, we laparoscopically completed the procedure successfully without converting to open surgery. CONCLUSIONS: Although da Vinci surgical system failure rarely occurs, surgical team should be prepared to convert to open or complete the procedure laparoscopically. Having previous laparoscopic experience seems to be an advantage in order to complete the procedure without converting to open. Patients should be informed about the possibility of robotic failure and about its consequences before the surgery.