Understanding How Surgical Errors May Occur with Da Vinci

The Da Vinci Surgical System by Intuitive Surgical Inc. is not really all that new. It was first approved by the Food and Drug Administration (FDA) for use in the US on July 11, 2000. While it made waves in the medical community when it was first made commercially available, it was only in the last three years that it became spotlighted for the general public. Unfortunately, it is because of the surgical errors and injuries that have become associated with the technology.

According to the National Injury Law Center, under usual circumstances, liability for surgical errors is placed on the surgeon as medical malpractice. However, with the use of the Da Vinci which is considered a supervisory-controlled robotic surgery system, the problem may be in the tool itself rather than the wielder. To understand how this can happen, one must know how the system works.

The da Vinci is made up of the surgical arm unit which is placed near the patient and a console for the surgeon who will be viewing and controlling the arm unit from several feet away. The system is designed so that the surgeon is the one making all the moves, using a joystick to control the motions of the three or four arms the robot may have. Small incisions are made in the abdomen in which stainless steel rods are placed. One of the rods is equipped with two endoscopic cameras while the others have surgical tools attached. The surgeon is then provided with a 3D image of the patient’s insides without having to actually open up the patient or touch the instruments.

There are two ways that are immediately apparent that surgical errors may occur. One is based on the lack of physical contact between the surgeon and patient could affect how the surgeon intuits the condition of the patient, something that may be balanced out with proper training. The other is the use of electrical instrument which may malfunction at any time. Surgeons have reported numerous incidents of a system freeze or shutdown in the middle of a procedure, necessitating a switch to more traditional surgical methods. Some patients experience inadvertent electrical burns to internal organs. These may all be considered surgical errors leading to injury.

The Da Vinci system has its merits, but it has a long way to go before it can be all that it can be in surgery.

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