Updated: Aug 24
In the last decade, we have witnessed the great potential of a Cognitive Revolution in surgery.
Cognition is “the action or faculty of knowing”.
Recent progress in one of its major subfields, artificial intelligence (AI), has created the promise of revolution.
A revolution is a “dramatic or wide-reaching change in conditions”.
Examples include the Industrial Revolution, which jump-started modern society by transitioning manual labor into machine-assisted processes.
Surgery has also undergone many revolutions.
In the 19th century, the development of general anesthesia and asepsis allowed surgeons to perform invasive surgical procedures safely.
The 20th-century innovations of surgical staplers, endoscopy, and laparoscopy have created modern surgery as we know it.
Almost 30% of surgical patients will suffer a complication despite this progress.
Surgery must improve, and AI offers a potential solution: the Cognitive Revolution.
Updated: Aug 24
Over the past two decades, surgical education has undergone a profound makeover.
Traditional apprenticeships have evolved into competency-based training, tailored to the demands of the 21st century. The volume of knowledge has surged exponentially, challenging surgical trainees to keep up.
Simultaneously, surgical techniques have advanced, transitioning from open procedures to minimally invasive and image-guided methods.
These innovations demand extensive and extended training to attain proficiency.
Lately, AI has emerged as a potent force capable of reshaping healthcare and surgical education.
Skill Acquisition
The rapid evolution of surgical innovation has outpaced advancements in surgical training. Reduced operative experience during residency, owing to restricted work hours and increased administrative responsibilities, poses a significant challenge.
Virtual-reality (VR)-based training, complemented by AI and machine learning, can bridge this gap.
VR platforms offer hands-on training experiences, while AI provides unbiased personalized feedback to enhance skill acquisition.
Surgical Simulation
Machine learning, a subset of AI, can analyze VR simulation data to offer real-time feedback and facilitate skill development. This combination creates immersive training experiences and ensures trainees are well-prepared before they enter the operating room.
Intraoperative Guidance
Accurate performance assessment is essential for surgical trainees to become competent and safe surgeons.
Robotic surgery platforms, equipped with AI, can analyze data generated during surgery, providing objective skill assessments and constructive feedback. These platforms can track movements, speeds, and other metrics to assess the surgeon's proficiency.
AI can also analyze surgical videos to support decision-making, improve surgical quality, and enhance patient outcomes. For instance, AI models can efficiently identify whether specific critical surgical views have been achieved.
Updated: Aug 24
Some consider digital surgery as the surgery of the future, “fourth generation surgery”, “4.0 surgery” or smart surgery.
Recent advancements in digital technologies, including artificial intelligence (AI), machine learning (ML), augmented reality (AR), and virtual reality (VR), are propelling innovation growth to unprecedented levels.
Digital surgery: the fourth generation of surgery
Digital surgery is an evolution of robotic surgery initiated by Intuitive Surgical, which launched the revolutionary da Vinci system in 1999 in Europe and in 2000 in the United States to help surgeons perform mini-invasive surgery, more precise and less invasive surgery, with 3D vision.
Through its ability to provide the surgical team with scientific and analytical data, new knowledge, and 5G connectivity, the modern operating room can now reach higher levels of efficiency.
The advantages of digital surgery technologies:
Advanced surgical navigation and visualization
More precise and less invasive surgery
Reduction of surgeon distraction (having to look at a remote monitor) and cognitive load
Reduction of surgical errors
Improved communication between surgeons and decision-making
Real 3D surgical simulations for interactive surgical team practice
Smarter, less invasive, safer, and more personalized surgery.
The digital surgery ecosystem:
Recent technological advances in mini-invasive surgery, including the adoption of digital surgery ecosystems by several large medical device companies, dominate the space of robotic surgery through well-known robotic surgery platforms, such as intuitive surgery. (da Vinci platform) , J&J/Auris Health (MONARCH), and Medtronic (HUGO Robotic-Assisted Surgery, MAZOR X Stealth Edition).
Next-generation robotic surgical systems have also entered the market through key acquisitions of innovative startups, such as Verb Surgical and Orthotaxy (by J&J).
Surgeons can learn and improve through machine learning and AI. These advanced systems drive growth in the global market for digital surgical technologies and encompass the following six core technologies:
Preoperative planning
Pre-surgical anatomical recognition
Intraoperative visualization
Surgical navigation
Workflow management
Analysis of surgical performance
Overall, digital surgery allows the surgical team to get smarter data through artificial intelligence, advanced instrumentation, visualization, and connectivity.
Digital surgery promises surgical procedures with fewer surgical errors and complications, improving patient outcomes in an ever-expanding field of non-invasive surgery.
Digital surgery ushers in the era of patient-centricity. Rather than focusing solely on the anatomy, surgeons will operate with an enriched understanding of an individual’s specific attributes: including the human phenome, physiome, microbiome, genome, and epigenome.