Ethical implications of AI in robotic surgical training: A Delphi consensus statement

Collins, Justin; Marcus, Hani J.; Ghazi, Ahmed; Sridhar, Ashwin; Hashimoto, Daniel A.; Hager, Gregory D.; Arezzo, Alberto; Jannin, Pierre; Maier-Hein, Lena; März, Keno; Valdastri, Pietro; Mori, Kensaku; Elson, Daniel S.; Giannarou, Stamatia; Slack, Mark; Hares, Luke; Beaulieu, Yanick; Levy, Jeff; Laplante, Guy; Ramadorai, Arvind; Jarc, Anthony; Andrews, Ben; García, Pablo Pérez; Neemuchwala, Huzefa; Andrusaite, Alina; Kimpe, Tom; Hawkes, David J.; Kelly, John D.; Stoyanov, Danail

doi:10.1016/j.euf.2021.04.006

Cited by 31 publications

(13 citation statements)

References 29 publications

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“…Moreover, ethical and moral considerations regarding the democratization of data and/or AI model access will be necessary. In the specific context of surgery, first guidance on the ethical implications of integrating AI algorithms into surgical training workflows has recently become available ( Collins et al, 2021 ). Similarly, new concepts for obtaining patient consent to data sharing that take into account the dynamics and unforeseeability of data usage in future SDS applications need to be established.…”

Section: Clinical Translationmentioning

confidence: 99%

Surgical data science – from concepts toward clinical translation

Maier-Hein

Eisenmann

Sarıkaya

et al. 2022

Medical Image Analysis

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Section: Clinical Translationmentioning

confidence: 99%

Surgical data science – from concepts toward clinical translation

Maier-Hein

Eisenmann

Sarıkaya

et al. 2022

Medical Image Analysis

Self Cite

172

112

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“…Objective automated scores of surgical performance have huge potential to assess surgeons, predict patient outcomes and in the near future, give opportunities to personalize surgeon training. However, as the role of AI in healthcare continues to expand there is increasing awareness of the potential pitfalls of AI and the need for guidance to avoid them [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum

et al. 2023

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Robot-assisted surgery (RAS) continues to grow globally. Despite this, in the UK and Ireland, it is estimated that over 70% of surgical trainees across all specialities have no access to robot-assisted surgical training (RAST). This study aimed to provide educational stakeholders guidance on a pre-procedural core robotic surgery curriculum (PPCRC) from the perspective of the end user; the surgical trainee. The study was conducted in four Phases: P1: a steering group was formed to review current literature and summarise the evidence, P2: Pan-Specialty Trainee Panel Virtual Classroom Discussion, P3: Accelerated Delphi Process and P4: Formulation of Recommendations. Forty-three surgeons in training representing all surgical specialties and training levels contributed to the three round Delphi process. Additions to the second- and third-round surveys were formulated based on the answers and comments from previous rounds. Consensus opinion was defined as ≥ 80% agreement. There was 100% response from all three rounds. The resulting formulated guidance showed good internal consistency, with a Cronbach alpha of > 0.8. There was 97.7% agreement that a standardised PPCRC would be advantageous to training and that, independent of speciality, there should be a common approach (95.5% agreement). Consensus was reached in multiple areas: 1. Experience and Exposure, 2. Access and context, 3. Curriculum Components, 4 Target Groups and Delivery, 5. Objective Metrics, Benchmarking and Assessment. Using the Delphi methodology, we achieved multispecialty consensus among trainees to develop and reach content validation for the requirements and components of a PPCRC. This guidance will benefit from further validation following implementation.

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“…We followed this approach to explore the value of robotics in PFRS with the use of a Delphi methodology. This approach has recently become popular to assess robotic surgery [ 19 , 20 ], including training [ 21 ], and the role of innovations related to this surgical approach [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users

et al. 2023

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Background Robotic surgery has gained popularity for the reconstruction of pelvic floor defects. Nonetheless, there is no evidence that robot-assisted reconstructive surgery is either appropriate or superior to standard laparoscopy for the performance of pelvic floor reconstructive procedures or that it is sustainable. The aim of this project was to address the proper role of robotic pelvic floor reconstructive procedures using expert opinion. Methods We set up an international, multidisciplinary group of 26 experts to participate in a Delphi process on robotics as applied to pelvic floor reconstructive surgery. The group comprised urogynecologists, urologists, and colorectal surgeons with long-term experience in the performance of pelvic floor reconstructive procedures and with the use of the robot, who were identified primarily based on peer-reviewed publications. Two rounds of the Delphi process were conducted. The first included 63 statements pertaining to surgeons’ characteristics, general questions, indications, surgical technique, and future-oriented questions. A second round including 20 statements was used to reassess those statements where borderline agreement was obtained during the first round. The final step consisted of a face-to-face meeting with all participants to present and discuss the results of the analysis. Results The 26 experts agreed that robotics is a suitable indication for pelvic floor reconstructive surgery because of the significant technical advantages that it confers relative to standard laparoscopy. Experts considered these advantages particularly important for the execution of complex reconstructive procedures, although the benefits can be found also during less challenging cases. The experts considered the robot safe and effective for pelvic floor reconstruction and generally thought that the additional costs are offset by the increased surgical efficacy. Conclusion Robotics is a suitable choice for pelvic reconstruction, but this Delphi initiative calls for more research to objectively assess the specific settings where robotic surgery would provide the most benefit.

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Ethical implications of AI in robotic surgical training: A Delphi consensus statement

Cited by 31 publications

References 29 publications

Surgical data science – from concepts toward clinical translation

Surgical data science – from concepts toward clinical translation

Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum

Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users

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