达芬奇手术机器人系统故障分析及对策研究

Retrospective analysis and countermeasures of da Vinci surgical robot system faults

目的:分析达芬奇手术机器人系统故障数据,提出针对性的预防对策。方法:分析医院2017-2021年实施的3957例达芬奇手术机器人辅助手术中出现的45例故障资料(其中严重故障13例),以年度为周期,对手术例数与故障数、严重故障数、故障率及严重故障率进行相关性分析;同时分析机器人的医生控制台、床旁机械臂和图像车故障情况,对严重故障进行分析并提出预防对策。结果:2017-2021年度每年的年故障率分别为1.68%(8/475)、0.84%(5/598)、0.63%(6/947)、1.33%(11/830)和1.36%(15/1107),平均故障率为1.14%(45/3957);严重故障率分别为0.21%(1/475)、0.33%(2/598)、0.32%(3/947)、0.36%(3/830)和0.36%(4/1107),平均严重故障率为0.33%(13/3957),严重故障占全部故障的28.9%(13/45);手术机器人的磨合期、最佳期和性能下降期3个阶段分别为第1年、第2~3年和第4~5年。故障数、故障率、严重故障率与手术例数均无相关性,严重故障数与手术例数有显著相关性(r=0.87,P<0.05)。严重故障部位全部发生在床旁机械臂和图像车,床旁机械臂主要严重故障为镜头臂故障(占23.1%),图像车主要严重故障为摄像头故障(占38.5%);从摄像头故障、器械臂(含镜头臂)故障和日常维护管理3方面提出针对性的系统故障预防对策。结论:分析手术机器人故障得出机器人3个阶段的具体时间,据此可以更加合理地安排培训和预防性维护;针对器械臂(含镜头臂)和摄像头故障的预防对策及日常维护管理措施,能够提升达芬奇机器人管理水平。

Objective:To analyze the faults of Da Vinci surgical robot system,and to propose the corresponding preventive measures.Methods:Data of 45 faults(13 of which were serious faults)occurred in 3,957 cases of da Vinci surgical robotassisted surgeries carried out in five years in the hospital from 2017 to 2021 were retrospectively analyzed.Taking the year as the cycle,the correlation analysis was carried out on the number of surgical cases and fault number of surgical cases,the serious fault number,the fault rate,and the serious fault rate.At the same time,the faults of the doctor's console of the robot,the manipulator beside the bed and the image cart were analyzed,the serious faults were analyzed and the preventive measures were put forward.Results:The fault rates from 2017 to 2021 were 1.68%,0.84%,0.63%,1.33%,and 1.36%,respectively,and the average fault rate was 1.14%.The serious fault rates were 0.21%,0.33%,0.32%,0.36%and 0.36%,respectively.The average serious fault rate was 0.33%,and serious faults account for 28.9%of all faults.The three stages of running-in period,optimal period and performance decline period of surgical robot were the first year,the second to third year and the fourth to fifth year respectively.There was no correlation between the fault number,fault rate,serious fault rate and the number of surgeries.There was a significant correlation between the serious fault number and the number of surgeries(r=0.87,P<0.05).The serious faults all occurred in the manipulator beside the bed and the image cart.The main serious fault of the manipulator beside the bed was the lens arm fault,accounting for 23.1%.The main serious fault of image cart was the camera fault,accounting for 38.5%.The targeted system faults prevention measures were proposed from three aspects of camera fault,instrument manipulator(including camera arm)fault,and daily maintenance management.Conclusion:Through the analysis of surgical robot faults,the specific time of three stages of the da Vinci robot was obtained,so that training and preventive maintenance can be arranged more reasonably.The preventive countermeasures and daily maintenance management measures for instrument manipulator(including the lens arm)and camera faults can improve the management level of da Vinci robot.