From the hands of the robot to the courtroom

Abstract

Aims: The aim of this study was to evaluate the implications of robotic surgery on clinical risk and litigation at the Fondazione Policlinico "A. Gemelli" (FPG) to identify potential strategies to reduce future cases of controversies.

Materials and methods: We examined claims related to robotic surgeries performed at FPG from 2015 to 2024. The complication rate for each procedure was evaluated and compared to that of laparoscopic procedures. Subsequently, trends in litigation related to robotic-assisted surgery were analysed, taking into account findings from international literature on the topic.

Results: Our data demonstrate a 27% increase in claims, mainly involving Gynecology, Urology, and General Surgery. The primary causes of legal disputes were related to surgical errors and the need for additional procedures. The complication rate was higher in laparoscopic procedures compared to those performed with robotic assistance.

Conclusions: The number of claims analysed shows a growing trend, although robotic surgery represents a small proportion of the total number of procedures performed. This finding should encourage healthcare facilities to adopt appropriate tools for assessing and monitoring risks associated with robot-assisted procedures. These tools will help strengthen the skills and training of healthcare workers, as well as improve doctor-patient communication, thus promoting a reduction in claims and an overall improvement in the healthcare experience.

Keywords: clinical risk management; litigation; malpractice; robotic surgery.