Robotic Surgery Safety: A Checklist Approach

Questions about robotic surgery safety are consistently in the news, including coverage of a recent draft analysis by Rush University Medical Center that found since 2000, there have been 4,798 adverse events involving the da Vinci Surgical System reported to the FDA. These events included more than 3,400 device malfunctions, which could result in an intraoperative crisis and require the surgical team to move from robotic surgery to traditional open surgery.

Though rare, this time‐critical situation puts patient safety at risk and requires quick and accurate action by the surgical team. Furthermore, relying on staff recall of emergency procedures can lead to large deviations from standard of care. To minimize these deviations and help ensure patient safety, Memorial Sloan Kettering developed a Robotic Surgery Intraoperative Crisis Checklist – the first-ever checklist approach for seamlessly and rapidly transitioning from robotic to open surgery.

Each member of the surgical team has a very specific role in case of emergency. The team collectively reviews these individual roles during the time-out procedure at the beginning of the case. At Memorial Sloan Kettering, each fellow and faculty member who performs robotic surgery is required to prepare for an emergency procedure by training with the checklist, which is adaptable to any robotic operating room and, in a critical situation, can help a surgical team maximize patient safety.

Memorial Sloan Kettering urologic surgeon Vincent Laudone is available to discuss the checklist and its impact on patient safety during robotic procedures.