A Review on the Current Applications of Artificial Intelligence in the Operating Room

Abstract

Background. Artificial intelligence (AI) is an era upcoming in medicine and, more recently, in the operating room (OR). Existing literature elaborates mainly on the future possibilities and expectations for AI in surgery. The aim of this study is to systematically provide an overview of the current actual AI applications used to support processes inside the OR. Methods. PubMed, Embase, Cochrane Library, and IEEE Xplore were searched using inclusion criteria for relevant articles up to August 25th, 2020. No study types were excluded beforehand. Articles describing current AI applications for surgical purposes inside the OR were reviewed. Results. Nine studies were included. An overview of the researched and described applications of AI in the OR is provided, including procedure duration prediction, gesture recognition, intraoperative cancer detection, intraoperative video analysis, workflow recognition, an endoscopic guidance system, knot-tying, and automatic registration and tracking of the bone in orthopedic surgery. These technologies are compared to their, often non-AI, baseline alternatives. Conclusions. Currently described applications of AI in the OR are limited to date. They may, however, have a promising future in improving surgical precision, reduce manpower, support intraoperative decision-making, and increase surgical safety. Nonetheless, the application and implementation of AI inside the OR still has several challenges to overcome. Clear regulatory, organizational, and clinical conditions are imperative for AI to redeem its promise. Future research on use of AI in the OR should therefore focus on clinical validation of AI applications, the legal and ethical considerations, and on evaluation of implementation trajectory.

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“…Surgeons are less worried about job replacement compared to their colleagues in radiology. According to previous surveys in radiology and radiation oncology, 34%-42% of the physicians had a fear of (partial) replacement compared to 7% of the surgeons in this survey [23,25,40,41] . Surgeons' low concern on job replacement could be explained by the nature of their job, which requires fine complex manipulation during surgery and direct human interaction with patients.…”

“…This survey was created using Google Forms and distributed for two weeks in March 2021 to the Dutch Association for Surgery (Nederlandse Vereniging voor Heelkunde) members by email. The questions were developed after review of the current literature and included after consultations with a core group of surgeons of the study [2,[21][22][23][24][25][26] . Survey completion was voluntary and anonymous.…”

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