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Using the Electrosurgical Unit (ESU) with Monopolar and Bipolar Instruments
da Vinci SP Instruments and Accessories
56
DR
AFT/PRE-RELEASE/C
ONFIDENTIAL
12/5/19
If this type of EnergyShield Monitor failure occurs, the EnergyShield Monitor may be
non-functional and should not be used. The system will trigger a system recoverable fault
( Figure 8.19 ) which can be recovered to resume all system control modes and bipolar energy
activation of the VIO dV, but energy activation of EndoWrist SP monopolar instruments will be
prevented from the Surgeon Console. If this occurs, contact Intuitive Surgical Customer
Service.
Figure 8.19 Recoverable fault message example
Intraoperative Use
WARNING: Do not use monopolar instruments with a bipolar source output as this
may cause damage to the instrument and harm to the patient or medical personnel.
WARNING: Use the lowest power setting possible for the minimum time necessary
to achieve the desired effect.
WARNING: Excessive power or effect levels may result in instrument malfunction
and possible patient or user injury. Reduce power or effect setting if any of the
following effects are observed: excessive arcing, excessive tissue charring, excessive
overheating of the tip (for example, the tip glowing red or emitting a blue plasma
cloud).
WARNING: Exercise caution when working with monopolar instruments close to
other instruments. Unintended energy may be delivered from the active monopolar
instrument to a second instrument (EndoWrist SP or manual
laparoscopic). This
could result in burns to tissue in contact with any of the second instrument's metal
parts or port. To exercise caution in these scenarios, the monopolar tip should be
closer to the tissue than to the second instrument.
WARNING: The Monopolar Cautery Instrument should be cleaned and dried before
installing or exchanging any monopolar cautery tip.
WARNING: As with any electrosurgical device, it is possible for energy to discharge
in an area other than the instrument tip. It is important to exercise caution when
using an energized EndoWrist SP cautery instrument to help avoid unintended
contact with tissue adjacent to the area to be cauterized.
WARNING: Inspect the Instrument Sheath for damage throughout use. Examples of
damage include tears or cuts in the sheath material. If damage is observed, remove
and replace the Instrument Sheath on any instrument (monopolar or other) to
prevent stray cautery or other risks.