The authors present their single-institution experience with failures in the insulating silicone covers for the robotic mo-nopolar cautery scissors. This study included 454 robot-assisted procedures (urological and nonurological) that were performed over a 7-month period. A 2.6% accessory cover failure rate was observed. Most importantly, such instrument malfunction led to 3 significant intraoperative complications, including one external iliac vein injury, one small bowel cautery burn, and one distal ureteral cautery injury. Fortunately, all three complications were discovered at the time of surgery and were repaired with no further sequelae.
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