A Single-center Research On Malfunction Of The Da Vinci Robotic Surgery System And Countermeasures

ObjectivesTo research the reasons of the malfunctions of the da Vinci robotic surgery system and propose countermeasures and preventions for the malfunctions.MethodsThe malfunction data occurred during 1000 cases which underwent robot-assisted urology surgery from September 2014 to December 2016 were retrospectively analyzed.The information includes malfunctions occurrence time,specific descriptions,repair process and replacements information.All operations were assisted by a third generation of Da Vinci surgical robot developed by the Intuitive Surgical Inc from USA.1000 cases were divided into 5 groups on average according to the time sequence.The numbers of malfunctions for each group and days that each group underwent were counted separately.All malfunctions are classified according to different parts and systems involved.At the same time,the malfunctions can be divided into critical malfunctions and repairable malfunctions according to the influence degree on the operation process.The trend and characteristics of malfunctions are analyzed.ResultsA total of 15 malfunctions occurred during 1000 robot-assisted urology surgeries,with total malfunction rate of 1.5%.All of them were simple robot system malfunctions,and no Da Vinci robot surgical instrument malfunction occurred.Of these,9(60%,9/15)were male patients and 6(40%,6/15)were female patients,with an average age of 57.3 ± 16.9 years.Recoverable malfunctions occurred 11 times and recoverable malfunction rate was 1.1%.Critical malfunctions occurred 4 times and critical malfunction rate was 0.4%.There were 5 robotic arm system malfunctions.All of them were occurred before surgery,and the tension was repaired by robotic engineers replacing the mechanical arm or adjusting the rope of the manipulator.There were 3 endoscopic instrument failures,1 of which were unable to focus on the camera during the operation,the operation was changed to ordinary laparoscopy,and the other 2 endoscopic instrument failures delayed the operation.Of the 3 camera failures,1 were malfunctions of the camera software system,and the robotics engineer repaired the camera by restoring the camera;the other 2 were the hardware system failure of the camera,and the engineer repaired the camera by replacing the camera or the cable.Imaging system failure occurred in 3 cases,and power failure occurred in 2 cases,all of which resulted in delayed operation.There were 1 patient-side cart malfunction and 1 surgeon console malfunction,and no effect on the operation.The malfunction numbers of the five groups were 1,3,2,7 and 2 respectively,and the failure rates of each group were 0.5%,1.5%,1%,3.5%and 1%respectively.The five groups experienced 273 days,139,168,125 and 108 respectively.There was no significant correlation between the total number of malfunctions in each group and the number of days in each group(P>0.05).ConclusionsThe malfunction rate of da Vinci robot surgery system is extremely low and shows its special feature as the number of surgeries increases and maintenance for the machine.Critical malfunction is rear,which may have great impact on surgery once it occurs.The users should have adequate appreciation of the causes,countermeasures and preventive measures of the malfunctions,in order to mostly reduce the impact on surgeries.And with the emergence of new technology and product update,the shortage of da Vinci robot operation system will be gradually made up.The constantly updated da Vinci robot will have higher reliability and lower malfunction rate,so that the surgery can be more smooth and successfully.