Trocar-Adjacent Instrument Collision Causing Robotic Forceps Shaft Deformation Requiring an Instrument Release...

Robotic surgery offers stable three-dimensional visualization, yet limited haptics can permit excessive force when shaft motion occurs partly outside the endoscopic field. We report trocar-adjacent shaft collision causing robotic forceps deformation and locking that required an instrument release wrench. A 55-year-old woman with presumed stage IA endometrial cancer underwent robot-assisted hysterectomy using a da Vinci Xi system. After adhesiolysis created a workable corridor, the third- and fourth-arm instrument shafts collided near the cannula zone. The third-arm Maryland bipolar forceps became fixed in flexion with loss of jaw function. Energy activation was stopped, the instrument was disengaged using an instrument release wrench, and the damaged instrument was removed together with the trocar. Three carbon fragments and one wire fragment were retrieved, and the operation was completed robotically after instrument exchange. We propose an "avoidance-and-recovery" troubleshooting algorithm to support team preparedness for rare robotic instrument failure.