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Introduction: The da Vinci surgical system requires the use of electrosurgical instruments. The re-use of such
instruments creates the potential for stray electrical currents from capacitive coupling and/or insulation failure with
subsequent injury. The morbidity of such injuries may negate many of the benefits of minimally invasive surgery. We
sought to evaluate the rate and nature of electrosurgical injury (ESI) associated with this device.
Methods: The Manufacturer and User Facility Device Experience (MAUDE) database is administered by the US Food
and Drug Administration (FDA) and reports adverse events related to medical devices in the United States. We analyzed
all incidents in the context of robotic surgery between January 2001 and June 2011 to identify those related to the use of
electrosurgery.
Results: In the past decade, a total of 605 reports have been submitted to the FDA with regard to adverse events related
to the da Vinci robotic surgical platform. Of these, 24 (3.9%) were related to potential or actual ESI. Nine out of the 24
cases (37.5%) resulted in additional surgical intervention for repair. There were 6 bowel injuries of which only one was
recognized and managed intra-operatively. The remainder required laparotomy between 5 and 8 days after the initial
robotic procedure. Additionally, there were 3 skin burns. The remaining cases required conservative management or
resulted in no harm.
Conclusion: ESI in the context of robotic surgery is uncommon but remains under-recognized and under-reported.
Surgeons performing robot assisted surgery should be aware that ESI can occur with robotic instruments and vigilance
for intra- and post-operative complications is paramount.
Andrew Fuller,George A. Vilos, andStephen E. Pautler
"Electrosurgical injuries during robot assisted surgery: insights from the FDA MAUDE database", Proc. SPIE 8207, Photonic Therapeutics and Diagnostics VIII, 820714 (9 February 2012); https://doi.org/10.1117/12.909456
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Andrew Fuller, George A. Vilos, Stephen E. Pautler, "Electrosurgical injuries during robot assisted surgery: insights from the FDA MAUDE database," Proc. SPIE 8207, Photonic Therapeutics and Diagnostics VIII, 820714 (9 February 2012); https://doi.org/10.1117/12.909456