A forthcoming article in the Journal of Endourology has breaking news regarding
the risks of burns and thermal injuries due to a defect in the design
of the da Vinci robot. Doctors in the Department of Urology at Loma Linda
University Medical Center in California studied the tip cover accessory
(TCA) for the monopolar scissors used in the robotic surgery, the purpose
of which cover is to prevent electrical current from escaping, except
at the tip. In the study, the TCAs in use (up until recently) leaked electricity.
The insulation was often found by the naked eye to be broken, and in more
cases there were microscopic defects which allowed the electricity to
escape. The escape of electricity was where the surgeon would not expect
it. It was coming out on tissue which the doctors thought was protected
and damaging it with thermal burns. The incidence of escape was much higher
when the wrist feature on the robotic arm was more angulated. Perhaps
the most important finding as far as liability with the robot suits we
are handling is that there were much less leak problems with a newly improved
tip cover which had recently been devised for the da Vinci. It appears
that Intuitive had never alerted owners of older robotic machine and accessories
of the upgrade. The authors recommend that the older type of TCA no longer
be used. We have reason to believe the older device was in use when the
burn and death occurred in the McCalla case we are handling (see earlier
writeup). The article is A Prospective Analysis of Robotic Tip Cover Accessory
Failure, Engelbretsen et al, May 9 2012 advance publication.
