Robotic Surgery Blog: Robotic Equipment Archives

October 24, 2007

Robotic failure during surgery

Robot failure during radical prostatectomies is 'extremely rare' - Failure rates will continue to shrink as technology advances - UrologyTimes

The study team recorded critical failures in 20 cases (0.3%) leading to the cancellation of 10 procedures and conversion to laparoscopic in one case and to open procedure in nine cases. Recoverable failures were more frequent, occurring in 124 instances (1.9%). The most common malfunctions or failures occurred in the optical system and in the surgical arms. Failure of the master system or power system was less common.

Dr. Patel did not ask me to be in this studay, but my experience is simlar. I have 2 failures during my robotic surgery cases. 1 wa sduring a kidney removal operation and we converted to laparoscopy.
The other was during a prostate removal when we brough in one of the other 2 robots. Thats 2 in almost 500 operations.
We also had 1 cancellation, 1 delayed start, and 2 other cases that were done with only 3 arms.
I would call that 2 major problems and 4 minor problems.

March 2, 2007

Robotic Tips for Surgeons and Teams #1

This is a new topic to help explain some of the workings of the robotic systems.

This tip on black balance, white balance, and scope alignment comes form Sue Belluardo, my local intuitive surgical rep.

Remember 3 things:

- Black Balance is Camera Head Specific

- White Balance is Scope Specific

- Scope Alignment is Scope Angle Specific

Black Balance is not scope specific: Black Balance with either scope
will be fine. I suggest doing your Black Balance without a Scope Prior to
draping the Camera; cover the Optics of Camera Head with the palm of your
hand completely (or press and hold the Camera Optics toward your stomach)
and press both the "ABC Button" on both the Left and Right CCU. (The Red
LED's will stop blinking after about 20 Blinks; Black Balance is complete.
You will not have to Black Balance again unless you loose power to the CCU's or Vision Tower.)

White Balance should be done each time you choose a different scope
(each scope will transfer light differently through the scope at different
brightness levels).

Scope Alignment

- White Balance Scope

- Put the appropriate end of the Scope Alignment Tool on the appropriate
Scope

- Select the Scope Angle

- Focus on the Crosshairs

- Select Align Scope Button

- Bring the Crosshairs together by using the Arrow Buttons

- When the Crosshairs are aligned; Press and Hold until you hear the 3 happy chimes.....(On a Standard daVinci the button is labeled "Test Image" on the daVinci-S it's the the "Align Scope" button).

- Scope Alignment is Complete for the Selected Scope. Repeat the process
for the other Scope or Scope Angles.

The shortcut to remember is that black balance only needs to be done once, white balance twice (the 30 up and down are the same scope), and alignment 3 times if you plan on using the 30 up.

My team does all of these things prior to the patient coming into the room.

One time this was useful to know is when we dropped a scope (0 degree). It only took a white balance and 1 alignment of the new 0 scope.