The U.S. Food and Drug Administration (FDA) has received numerous reports of burns and electrocutions associated with the Da Vinci Robotic Surgery System. Unfortunately, a serious electrical burn during robot-assisted surgery can perforate blood vessels, damage organs, and cause serious bleeding that may need to be controlled with an emergency abdominal surgery.
UPDATE: Intuitive Warns Robot Scissors Can Burn Patients
May 13, 2013 — Intuitive has published a warning that the electrical scissors used to cut, cauterize, and burn tissue during robot surgery can develop “micro-cracks” in the insulation, which may allow electricity to arc and burn patients outside the surgical area. Click here to read more.
Burns from Robotic Surgery
The Da Vinci Surgical Robot System, manufactured by Intuitive Surgical, is rapidly growing in popularity for hysterectomies, prostatectomies, and other surgeries. Unfortunately, so has the number of adverse events involving burns and electrocutions — a serious complication unique to robotic surgery.
Burns and electrocutions are associated with the monopolar scissors, which are surgical instruments used in electrosurgery. The electrified instrument is attached to a robotic arm that is controlled by a physician at a console. An electrical current in the scissors is used to cut, cauterize, and coagulate tissues.
Physician errors can cause patients to be burned, especially if the electrified instrument touches a non-electrified instrument. A poorly-trained surgeon could also fire the electrical equipment unintentionally.
Other issues include mechanical malfunction and inadequate insulation. Researchers warn that this can cause electrical arcing, causing burns when electricity jumps from the robot to a patient’s body.
FDA Reports of Robotic Surgery Burns
The U.S. Food and Drug Administration (FDA) database contains numerous reports of burns during robotic surgery, including but not limited to:
- Report describes a routine hysterectomy that ended in a woman’s death. “The patient had sustained a burn to the right external iliac artery, pumping blood in the body cavity, causing bowel ischemia incompatible with life.”
- Report describes a prostatectomy (removal of the prostate gland) in which “… physicians assistant commented that he smelled garlic. Intra-operatively, it was immediately noticed that the monopolar scissors flamed, sparked and smoked at the joint when activated by the surgeon.”
- Report describes a case where the monopolar scissors “sparked through the intact protective sheath,” which “resulted in a vessel injury. After robotic suturing and attempted clipping of the defect was unsuccessful, the patient required emergency laparotomy.”
- Report describes a case where sparks from the monopolar scissors arced to an artery. According to the report, “The surface of the vessel was visibly charred.”
- Report describes a prostatectomy procedure, in which “arcing from the [monopolar scissors] occurred causing unintentional burning.”
Studies of Robotic Surgery Burns
Obstetrics and Gynecology published a study in August 2012 regarding burns in robotic surgery. The report described three case reports involving burns to blood vessels, including one case where the patient bled severely, required two blood transfusions, and surgeons had to perform an emergency laparotomy (large incision in the abdomen to access the abdominal cavity).
The researchers concluded that robotic surgery burns were caused by insulation failures in the monopolar scissors. They warned:
“Unintended electrosurgical arcs can occur from monopolar instruments. Insulation failure is a common finding in this type of injury.”
Side Effects and Complications of Robotic Surgery Burns
- Longer surgery time
- Blood vessel damage
- Severe bleeding
- Organ damage
- Tissue damage
- Bowel ischemia (loss of blood flow to intestines; can be fatal)
- Need for emergency laparotomy (emergency abdominal surgery)
- Scarring from emergency surgery
- Longer recovery time