Case Report DOI 10.3349/ymj.2010.51.1.148 pISSN: 0513-5796, eISSN: 1976-2437 Yonsei Med J 51(1): 148-150, 2010 A Unique Instrumental Malfunction during Robotic Prostatectomy Sung Yul Park, Jenny Jin-Kyung Ahn, Wooju Jeong, Won Sik Ham, and Koon Ho Rha Department of Urology, Urological Science Institute and Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea. Over the past decade, the introduction of robotics in the field of medicine has provided a new approach to patients requiring surgery, and both its advantages and disadvantages are currently under study by many groups worldwide. The use of robotics has especially been considered by the urological community as a treatment option in radical prostatectomy. The current case report is one in which the da Vinci Surgical SystemTM‚ with fourth arm use was employed in radical prostatectomy. This case presents a unique occurrence in which a bolt of the Prograsper forcep became loose during an operation, leading to diminished device functionality and later impedance of its removal. A circumstance such as this has not previously been reported, so we introduce for other robotic surgeons our unique instrumental malfunction case during a robotic prostatectomy. Key Words: Prostatectomy, robotics, malfunction Received: April 2, 2008 Revised: May 29, 2008 Accepted: May 29, 2008 Corresponding author: Dr. Koon Ho Rha, Department of Urology, Urological Science Institute and Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-2318, Fax: 82-2-312-2538 E-mail: khrha@yuhs.ac ∙The authors have no financial conflicts of interest. INTRODUCTION In recent years, the development of robotics for their application in the medical field has presented to surgeons an additional option in treating their patients. Robotic systems such as the da Vinci Surgical SystemTM have been introduced to the medical community and many centers worldwide have begun to include the use of these technologies in the treatment of patients. In the field of urology, robotics is currently being employed in addition to conventional open surgery. Robotic-assisted laparoscopic radical prostatectomy (RLRP) for the treatment of organ-confined prostate cancer is one such example.1 RLRP has had a wide diffu- sion in the last 5 years. In recent reports, RLRP has a short learning curve and better postoperative and functional outcomes.2,3 With several groups conducting robotic surgeries in urology, it is expected that the utility of robotic surgery will be thoroughly evaluated and will aid in the further development of robotic systems for use in the healthcare sector. Zorn, et al.4 reported that the device failure rate of da Vinci Surgical SystemTM was 0.5%, and there were subsequently no instru- mental malfunctions. Thus, device failure leading to case conversion or abortion may be higher during a surgeon’s initial RLRP experience. We introduce for other robotic surgeons our unique case during which a bolt of the Prograsper forcep became loose during a robotic prostatectomy. CASE REPORT A 56-year-old Korean male presented with prostate adenocarcinoma. The © Copyright: Yonsei University College of Medicine 2010 148 Yonsei Med J http://www.eymj.org Volume 51 Number 1 January 2010