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April 22, 2026Asian Journal of Endoscopic Surgery0 citations

Trocar‐Adjacent Instrument Collision Causing Robotic Forceps Shaft Deformation Requiring an Instrument Release Wrench: A Case Report With a Troubleshooting Algorithm

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KOKuniaki OtaYOYoshiaki OtaKTKeitaro Tasaka

Key Points

  • The case report investigates the incident of robotic forceps deformation due to trocar-adjacent collision during surgery.
  • Reported a case of a 55-year-old woman undergoing robotic hysterectomy.
  • Described the collision of robotic instrument shafts near the cannula and the subsequent instrument failure.
  • Proposed a troubleshooting algorithm for managing instrument failures during robotic surgery.
  • The third-arm forceps became fixed in flexion, losing jaw function due to collision.
  • Retrieved four fragments of the instrument post-failure: three carbon and one wire.
  • Operation was successfully completed with instrument exchange after troubleshooting.

Abstract

Robotic surgery offers stable three-dimensional visualization, yet limited haptics can permit excessive force when shaft motion occurs partly outside the endoscopic field. We report trocar-adjacent shaft collision causing robotic forceps deformation and locking that required an instrument release wrench. A 55-year-old woman with presumed stage IA endometrial cancer underwent robot-assisted hysterectomy using a da Vinci Xi system. After adhesiolysis created a workable corridor, the third- and fourth-arm instrument shafts collided near the cannula zone. The third-arm Maryland bipolar forceps became fixed in flexion with loss of jaw function. Energy activation was stopped, the instrument was disengaged using an instrument release wrench, and the damaged instrument was removed together with the trocar. Three carbon fragments and one wire fragment were retrieved, and the operation was completed robotically after instrument exchange. We propose an "avoidance-and-recovery" troubleshooting algorithm to support team preparedness for rare robotic instrument failure.

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Cite This Study

Ota et al. (2026) studied this question.

synapsesocial.com/papers/69e865926e0dea528ddea0c9https://doi.org/10.1111/ases.70291
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