Equipment Failure during Urological Surgery: Implications and Lessons to be Learned.

Abstract

The literature on the exact incidence of equipment failure during urological surgery is rather heterogeneous. Although failure rates are unacceptably high in other surgical disciplines, more compelling evidence is needed in urology. The present study provides case examples to illustrate several instances of urological instrument malfunction encountered in daily surgical practice, from the field of endourology to the newer robotic systems. Five cases of endourological device failures involving a resectoscope, a semi-rigid ureteroscope and alligator forceps and one case involving monopolar scissors of the Hugo RAS robotic system are presented, without any resultant complications to patients. Urologists and surgical personnel need to become acquainted with various equipment utilised in their field. Initiatives aimed at improvement of handling, inspection and prompt replacement of defective devices, rigorous adherence to manufacturers' guidelines, implementation of evaluative checklists for quality control and the adoption of incident-specific reporting forms are commendable actions toward enhancing operational efficiency. In the context of robotic surgery, a team of technical experts possessing sufficient knowledge of the equipment should offer continuous assistance in accordance with troubleshooting protocols. By implementing a standardised problem-solving strategy, they could diagnose and rectify emerging errors promptly and efficiently. Overall, failure in the theatre demands collective understanding and prompt management. Urologists need to communicate such events and collaborate to improve overall surgical efficiency.