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Emergency Undocking in Robotic Surgery: A Simulation Curriculum

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Implications of equipment failure occurring during surgery.

C A Efthymiou¹, A R Cale²

¹University Hospitals of Leicester NHS Trust, UK.

Annals of the Royal College of Surgeons of England

|April 21, 2022

Summary

Equipment failure is common during cardiac surgery, with 92% of operations experiencing issues, primarily with surgical instruments. This high incidence necessitates routine inspections to ensure patient safety and prevent costly cancellations.

Keywords:

Cardiac equipment malfunction Instrument accountability Instrument maintenance Quality control Risk management

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Area of Science:

Cardiovascular Surgery
Surgical Technology
Patient Safety

Background:

Formal studies on intraoperative equipment failure frequency are scarce.
Surgical instruments and equipment degrade over time, impacting performance.
No established requirements exist for routine instrument inspection or maintenance.

Purpose of the Study:

To investigate the frequency of intraoperative equipment malfunction during cardiac surgical procedures.
To identify common types of equipment failures in cardiac surgery.
To assess the impact of equipment failure on surgical case progression.

Main Methods:

Cardiac surgeons reported equipment malfunctions during a 12-month period.
Equipment was categorized into theatre infrastructure, large medical equipment, and surgical instruments.
Data collection focused on the incidence and nature of intraoperative failures.

Main Results:

A significant 92% of cardiac surgeries encountered equipment issues.
The most frequent malfunctions involved fine surgical instruments, such as worn needle holders and blunt scissors.
Failures in theatre infrastructure and large equipment led to four case cancellations, with some instrument failures posing catastrophic risks.

Conclusions:

The incidence of equipment failure in cardiac surgery is unacceptably high.
Equipment malfunction can lead to case cancellations and financial losses.
Annual compulsory inspections for surgical instruments are recommended to improve safety and quality.