Emergency Undocking in Robotic Urology Surgery - Preparedness, Protocols, and Practice

Gang ZhuChina Moderator Enhancing Robotic Surgery with AI and Imaging Navigation: Bridging Precision and Efficiency

Wenjie ZhongAustralia Speaker Emergency Undocking in Robotic Urology Surgery - Preparedness, Protocols, and PracticeIntroduction: Robotic surgery has revolutionized urologic procedures, offering precision and minimally invasive benefits. However, the complexity of the robotic interface introduces the rare but potentially catastrophic need for emergency undocking - a rapid disengagement of the robotic system in response to patient or technical emergencies. Objective: To review the current best practices, protocols, and preparedness strategies for emergency undocking during robotic urologic surgery, with a focus on multidisciplinary coordination, training, and outcome optimization. Methods: A structured review of the literature was conducted, including case reports, institutional protocols, and guideline recommendations from leading urological societies (AUA, EAU). In addition, procedural algorithms and simulation-based training approaches were analyzed to assess their impact on team performance and patient safety. Results: Emergency undocking occurs in fewer than 0.1% of robotic cases but is associated with high morbidity if delays occur. Key indications include sudden hemodynamic collapse, cardiac arrest, airway compromise, and robotic system malfunction. Simulation training has been shown to improve undocking times by up to 35%. Effective response hinges on predefined roles, verbal cues, and practiced protocols. Institutions with regular team drills report faster response times and better outcomes in high-acuity scenarios. Conclusion: Although infrequent, emergency undocking represents a critical moment in robotic surgery that demands rapid, coordinated team action. Implementing standardized protocols, reinforcing multidisciplinary simulations, and fostering a culture of readiness can significantly improve patient safety and surgical outcomes.