Malfunctions in real with da Vinci surgery
Recently, a great review article appeared in the Open Medicine journal from Alessia Ferrarese et al: Malfunctions of robotic system in surgery: role and responsibility of surgeon in legal point of view. Moreover, it is open access. Earlier, we have also covered this issue on SurgRob.
Abstract: "Robotic surgery (RS) technology has undergone rapid growth in the surgical field since its approval. In clinical practice, failure of robotic procedures mainly results from a surgeon’s inability or to a device malfunction. We reviewed the literature to estimate the impact of this second circumstance in RS and its consequent legal implications. According to data from the literature, device malfunction is rare. We believe it is necessary to complement surgical training with a technical understanding of RS devices."
The conclusion: "– In clinical practice, failure of robotic procedures mainly results from a surgeon’s inability or to a device dysfunction.
– The likelihood of the a patient’s being damaged not directly by the actions of the operator, but rather from the RS device, has always been a debated among robotic surgeons and legal medicine specialists.
– The learning curve involved in RS should consider both a purely technical part and a part to master the use of the device and resolution of technical problems.
In total, from 2005 to 2014, 386 malfunctions were described out of 14141 procedures (2.7%), 20.9% of which was damage caused by malfunc - tion of the RS arms and instruments. The total percentage of conversion in reported cases was about 2%. From a RS malfunction, 16 caused patient damage, of which 13 were mild and resolved without sequelae, and 3 were complex, including an external iliac vein lesion, ileal perforation, and urethral lesion."
– The likelihood of the a patient’s being damaged not directly by the actions of the operator, but rather from the RS device, has always been a debated among robotic surgeons and legal medicine specialists.
– The learning curve involved in RS should consider both a purely technical part and a part to master the use of the device and resolution of technical problems.
In total, from 2005 to 2014, 386 malfunctions were described out of 14141 procedures (2.7%), 20.9% of which was damage caused by malfunc - tion of the RS arms and instruments. The total percentage of conversion in reported cases was about 2%. From a RS malfunction, 16 caused patient damage, of which 13 were mild and resolved without sequelae, and 3 were complex, including an external iliac vein lesion, ileal perforation, and urethral lesion."
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