Da Vinci Malfunctions: How Safe Is Robotic Surgery?
Over the past two decades, robotic surgery has significantly reshaped surgical care, offering improved precision and less invasiveness than traditional approaches. The da Vinci system currently dominates the global market, with more than 2.6 million procedures performed in 2024. In Italy, da Vinci platforms have been in use for over 25 years and are now installed in more than 200 hospitals, where they have been used to treat hundreds of thousands of patients each year. Despite this widespread adoption, comprehensive safety analyses, particularly regarding the frequency and clinical impact of technical malfunctions, are lacking. This is a key gap, particularly as new robotic platforms are emerging and must be evaluated against current standards.
Surgery Comparison
The COMPARE study, published in the Annals of Surgery , is the largest comparative analysis to date of robotic, laparoscopic, and open oncologic surgeries. This study reviewed data on 3.9 million procedures from 230 publications across 22 countries. It included 34 randomised controlled trials, 74 prospective studies, and 122 database studies. The procedures examined included seven complex cancer surgeries performed using the da Vinci robotic surgical system between 2010 and 2022: lung lobectomy, total or radical hysterectomy, radical prostatectomy, partial nephrectomy, right colectomy, low anterior resection, and total mesorectal excision and/or intersphincteric resection for rectal cancers.
A total of 1,194,559 robotic procedures using the da Vinci system were compared with 1,095,936 laparoscopic and video-assisted thoracoscopic procedures and 1,625,320 open surgeries. The primary outcomes included conversion to open surgery, operative time, estimated blood loss, transfusion rate, length of hospital stay, 30-day postoperative complications, readmissions, reoperations, and mortality rates.
Robotic surgery took longer than laparoscopy (mean difference [MD], 17.73 minutes) and open surgery (MD, 40.92 minutes), but this was offset by the key clinical benefits. Hospital stays were shorter than those with laparoscopy (MD, -0.51 days) and open surgery (MD, -1.85 days), and blood loss was significantly lower than that with open surgery (MD, -293.44 mL). Robotic surgery reduced the risk for conversion to open surgery by 56% compared with laparoscopy. The transfusion risk was 21% lower than that of laparoscopy and 75% lower than that of open surgeries. Thirty-day complication rates were 10% and 44% lower than those of laparoscopy and open surgery, respectively. Mortality was reduced by 14% and 46% compared with laparoscopy and open surgery, respectively. Overall, robotic surgery showed improved safety for patients.
Few Malfunctions
Complications related to technical malfunctions are rare; however, how rare are they? A systematic review published in the World Journal of Urology , led by Nicolò Maria Buffi, MD, and Andrea Piccolini, MD, from the Department of Urology at the IRCCS Humanitas Research Hospital and Humanitas University in Milan, Italy, addressed this question. The review included 25 studies published over the past 20 years, covering 3,308,134 robotic procedures and 12,986 malfunctions of the da Vinci surgical system.
Malfunction was defined as any unintended failure involving the robotic console, patient cart, instruments, or accessories that disrupted the workflow, required troubleshooting, caused delays, led to conversion, or resulted in patient injury. Malfunctions were classified as device-related (console or cart) or instrument-related (tools).
A related study in European Urology , led by Marco Paciotti, MD, from the Department of Biomedical Sciences, Humanitas University, and the Department of Urology, IRCCS Humanitas Research Hospital, analysed Intuitive Surgical data from 1,835,192 da Vinci X and Xi procedures performed globally in 2022, focusing on system‑generated customer messages, which are alerts generated by the da Vinci system in response to technological problems or incorrect platform use.
The meta-analysis reported a malfunction rate of 1%, with device malfunctions in 0.11%, instrument issues in 0.37%, and conversion due to malfunction in 0.09%. Among all the malfunctions, 12.9% led to conversion to open surgery and 7.7% to laparoscopy. Injuries linked to malfunctions were estimated at 0.01%-0.02%, typically minor and mostly due to electrical arcing (193 of 308 cases), causing limited tissue damage or burns.
System Reliability
Manufacturer data showed that 1,790,244 of the 1,835,192 planned procedures (97.55%) were completed without alerts. Alerts occurred in 44,948 procedures (2.45%), totalling 140,986 events. Of these, 81.18% (114,447 events) resolved without rebooting. Technical support was obtained for 14,231 procedures. Only 1202 procedures (0.07%) were interrupted due to alerts, and 945 cases (0.05%) required conversion. The specific causes of alerts and clinical outcomes were not analysed; therefore, a direct link between alerts and outcomes could not be determined.
Setting Standards
Buffi emphasised the need for clear benchmarks on the da Vinci system's reliability and malfunctions. 'Over the last 5-6 years, there has been a significant introduction of new robotic systems. Given that the da Vinci system (with which I specify that I have no conflict of interest) has a long history and is considered extremely reliable, I thought it was appropriate to establish benchmarks for the reliability of robotic surgery. This is important because we risk focusing on economics, that is, on the cost of one robotic system compared to another, without considering the advantages and reliability of the machine,' he said to Univadis Italy , a Medscape Network platform.
Buffi also highlighted a major gap in the field: 'Currently, there is no true standard for assessing the reliability of robotic systems; only the CE approval process is required.'
According to Buffi, the da Vinci platform, particularly the latest models, has proven to be extremely safe. He explained that most issues in robotic surgery are linked to human error rather than flaws in technology. This underscores the crucial need for thorough training and education of healthcare professionals.
The key challenge is to effectively evaluate new platforms against current standards and ensure robust quality criteria for new entrants in the market.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Verge
an hour ago
- The Verge
What is it really like to go off the rails with ChatGPT?
From ChatGPT to Gemini: how AI is rewriting the internet See all Stories Posted Aug 9, 2025 at 3:09 PM UTC Follow topics and authors from this story to see more like this in your personalized homepage feed and to receive email updates. Richard Lawler Posts from this author will be added to your daily email digest and your homepage feed. See All by Richard Lawler Posts from this topic will be added to your daily email digest and your homepage feed. See All AI Posts from this topic will be added to your daily email digest and your homepage feed. See All News Posts from this topic will be added to your daily email digest and your homepage feed. See All OpenAI
CNN
an hour ago
- CNN
Crab vs. machine: Robot tests fiddler crab courtship tactics
Researchers test fiddler crab mating strategies by introducing a robot with a waving claw, dubbed 'Wavy Dave.' CNN speaks to one of the scientists about the study and some surprising moments caught on camera.
Yahoo
2 hours ago
- Yahoo
Coffee vs. Tea—Is One Healthier Than the Other? Dietitians Weigh In
Reviewed by Dietitian Katey Davidson, RD, CPTKey Points Both rich in antioxidants, coffee and tea offer their own unique benefits. Coffee and tea boost focus and performance and support heart and brain health. Skip added sugar and heavy creamers for a healthier centuries, coffee and tea have been among the world's most cherished beverages. Whether it's a bold cup of coffee to jump-start your day or a calming mug of tea to unwind at night, these drinks offer more than just comfort—they're also packed with potential health benefits. But when it comes to choosing the healthier option, which one takes the crown? If you have ever wondered whether coffee or tea is better for your health, read on. We've asked experts to break down the science to help you decide. Health Benefits of Coffee Coffee lovers, rejoice! This caffeinated beverage is more than just an energy booster. It comes with an impressive list of health benefits that can improve your well-being when consumed in moderation. It's Rich in Antioxidants Antioxidants help protect your cells from damage caused by free radicals—unstable molecules that can raise your risk of chronic diseases like heart disease and diabetes. In particular, coffee is rich in chlorogenic acid, a powerful antioxidant that may support gut health, improve blood sugar control, protect against cognitive decline and promote heart health. In fact, research shows that coffee is one of the largest sources of antioxidants in the average Western diet. It Supports Brain Health Regular coffee consumption has been linked with a lower risk of neurodegenerative diseases like Alzheimer's and Parkinson's. In fact, one study found that drinking one to two cups of coffee per day was associated with a 32% lower risk of developing Alzheimer's disease. Interestingly, the benefits appeared to extend up to four cups per day, but beyond that, the risk began to slightly increase—highlighting the importance of moderation. One reason why coffee may protect against cognitive decline is that the caffeine in coffee boosts neurotransmitters like dopamine and norepinephrine, which may enhance brain function. 'While coffee won't cure these diseases, moderate intake is associated with a lower likelihood of developing them as you age,' shares Toby Amidor, M.S, RD, a registered dietitian. It's Good for Your Heart Although too much caffeine can increase blood pressure temporarily, moderate coffee consumption has been associated with better heart health. In fact, a recent meta-analysis found that higher coffee intake was linked to a lower risk of developing hypertension (high blood pressure). Other studies have also connected regular coffee drinking to a reduced risk of heart failure and better cholesterol levels. These benefits may be due to coffee's antioxidant and anti-inflammatory properties, which help protect cells from inflammation-related damage. It Aids Physical Performance There's a reason coffee is a top pre-workout drink for many fitness enthusiasts—and why leading sports researchers recommend it as an ergogenic aid. In fact, a position statement from the International Society of Sports Nutrition concluded that caffeine can effectively enhance physical performance in athletes and non-athletes. So, before reaching for a pre-workout supplement, try enjoying a cup of coffee 30 to 60 minutes before your workout. Health Benefits of Tea Tea is an equally powerful contender when it comes to health benefits. Whether it's green, black or herbal, this versatile drink offers its own unique treasures. Source of Polyphenols Technically, 'true' tea comes from the leaves of Camellia sinensis, which includes green, black, oolong and white teas. This distinction is important because herbal teas differ in their nutritional benefits. True teas are rich in polyphenols, especially catechins and flavonoids, which have powerful antioxidant benefits. Green tea is especially known for its high levels of epigallocatechin gallate (EGCG), a compound with strong anti-inflammatory and cancer-fighting properties. These polyphenols may support overall health and help combat oxidative stress to lower your risk of chronic disease. Promotes Heart Health Like coffee, tea has been associated with improved heart health. A review of studies suggests that green tea consumption may benefit heart health by reducing key risk factors, like lowering both systolic and diastolic blood pressure as well as LDL ('bad') cholesterol levels. Experts believe these benefits come from the antioxidants in tea that fight oxidative stress and inflammation, which can damage the heart and blood vessels. These compounds also improve blood vessel function, increasing flexibility to support healthy blood flow and reduce strain on the heart. Supports Digestive Health If you're a fan of herbal tea, rest assured—it offers health benefits too. In fact, certain types of herbal tea, like peppermint and ginger, can work wonders for your digestive system. These teas may soothe bloating, improve gut motility and even reduce nausea. 'The compounds in certain herbal teas may aid digestion and can be a great option for a post-meal ritual,' says Amidor. For example, peppermint has been used for centuries to help with digestive issues. It contains an active ingredient known as menthol, which has been shown to relax the muscles of the digestive tract. This muscle-relaxing effect can help reduce spasms and discomfort, making peppermint tea particularly useful for people who need digestive support. It's Calming Unlike coffee, which is often praised for its energizing effects, tea tends to have a calming effect—thanks to a compound known as L-theanine. This amino acid promotes relaxation by increasing alpha brain wave activity and boosts calming neurotransmitters linked to focus and stress reduction. While tea does contain caffeine, L-theanine helps to counteract the jittery effects often associated with coffee. The Final Verdict When it comes to deciding whether coffee or tea is the healthier pick, there's no clear answer. Both have unique benefits that make them excellent choices depending on your health goals and preferences. "Coffee and tea both have research-backed health benefits, but the key is moderation," explains Jaclyn London, M.S., RDN. Most experts suggest sticking to a maximum of three to four cups per day and being mindful of any added sugar or high-fat creamers that could diminish their positive effects. How to Enjoy Coffee and Tea for Maximum Benefits For Coffee: For a healthier cup, opt for black coffee or add just a splash of milk. Ideally, skip the sugary syrups and high-fat whipped cream. If you prefer a smoother, less acidic taste, give cold brew coffee a try. For Tea: Green and black teas are fine on their own, but for added flavor, try adding a squeeze of lemon or a drizzle of honey. It's also important to listen to your body. Some people feel their best with tea, while others tolerate coffee just fine. But if coffee leaves you feeling jittery or anxious, swapping it for a calming tea may be the better option for you. Our Expert Take Whether you prefer the bold kick of coffee or the gentle comfort of tea, both can be a part of a healthy lifestyle—and each is a winner in its own right. Just remember that moderation is key and the way you consume these beverages plays a big role in their health benefits. So go ahead and sip your favorite brew with confidence, knowing that both are great picks for a healthier you. Read the original article on EATINGWELL
