Related Experiment Video
Updated: May 20, 2026
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Electrocautery-associated vascular injury during robotic-assisted surgery
Beatrice Cormier1, Farr Nezhat, Jason Sternchos
1From the Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, and the Division of Minimally Invasive Gynecologic and Robotic Surgery, Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, New York, New York.
Background:
The robotic surgical platform is increasingly used in gynecology and, similar to laparoscopy, it has risks of electrocautery-associated injury.
Case:
We present three cases of injury caused by failures of the monopolar scissors' insulating sheath while coagulation and cutting currents were set at 35 W. In case 1, an external iliac vein injury required blood transfusion and emergent laparotomy. In case 2, a full-thickness external iliac artery injury was repaired robotically. In case 3, a partial-thickness external iliac artery injury also was repaired robotically.
Conclusion:
Unintended electrosurgical arcs can occur from monopolar instruments. Insulation failure is a common finding in this type of injury. Surgeons should avoid excessive instrument collisions and should change the monopolar scissors' insulating sheath if there are any concerns of a defect in its integrity.