White paper: definitions of artificial intelligence and autonomous actions in clinical surgery

Gumbs, Andrew A.; Alexander, F.; Karcz, Konrad; Chouillard, Élie; Croner, Roland S.; Coles‐Black, Jasamine; Simone, Belinda De; Gautier, Michel; Gayet, Brice; Grasso, Vincent; Illanes, Alfredo; Ishizawa, Takeaki; Milone, Luca; Özmen, Mehmet Mahir; Piccoli, Micaela; Spiedel, Stefanie; Spolverato, Gaya; Sylla, Patricia; Vilaça, João L.; Swanström, Lee L.

doi:10.20517/ais.2022.10

Cited by 17 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally, the integration of artificial intelligence (AI) in pancreatic cancer surgery is set to transform decision-making in the coming years by tailoring open, laparoscopic, and robotic strategies based on detailed analyses of clinical, pathological, and radiological data [ 42 , 43 , 44 ]. AI algorithms, acting as robust decision support tools, address the complex dilemma of selecting the most suitable surgical approach by enhancing preoperative planning precision in left pancreatic tumors [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…This project aims to develop an AI algorithm that combines radiologic imaging, whole genomic sequencing, oncopathological data, and therapeutic responses to provide a precision therapeutic plan based on the patient’s entire oncologic profile [ 42 ]. As AI technology progresses, these advancements hold the promise of refining and optimizing surgical approaches for individual patients undergoing pancreatic cancer surgery [ 42 , 43 ]; however, many ethical and technical obstacles still remain [ 44 , 45 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Acciuffi,

Hilal,

Ferrari

et al. 2024

Cancers

Self Cite

View full text Add to dashboard Cite

Background: Minimally invasive surgery is increasingly preferred for left-sided pancreatic resections. The SIMPLR study aims to compare open, laparoscopic, and robotic approaches using propensity score matching analysis. Methods: This study included 258 patients with tumors of the left side of the pancreas who underwent surgery between 2016 and 2020 at three high-volume centers. The patients were divided into three groups based on their surgical approach and matched in a 1:1 ratio. Results: The open group had significantly higher estimated blood loss (620 mL vs. 320 mL, p < 0.001), longer operative time (273 vs. 216 min, p = 0.003), and longer hospital stays (16.9 vs. 6.81 days, p < 0.001) compared to the laparoscopic group. There was no difference in lymph node yield or resection status. When comparing open and robotic groups, the robotic procedures yielded a higher number of lymph nodes (24.9 vs. 15.2, p = 0.011) without being significantly longer. The laparoscopic group had a shorter operative time (210 vs. 340 min, p < 0.001), shorter ICU stays (0.63 vs. 1.64 days, p < 0.001), and shorter hospital stays (6.61 vs. 11.8 days, p < 0.001) when compared to the robotic group. There was no difference in morbidity or mortality between the three techniques. Conclusion: The laparoscopic approach exhibits short-term benefits. The three techniques are equivalent in terms of oncological safety, morbidity, and mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Acciuffi,

Hilal,

Ferrari

et al. 2024

Cancers

Self Cite

View full text Add to dashboard Cite

show abstract

“…AI research in surgery involves algorithms and the development of semi-autonomously acting devices and robotics capable of doing interventional gestures/actions in different surgical procedures by a different interaction with the surgeon, but always under his/her supervision. This interaction and supervision had been classified into 6 levels, as summarized in Table 1 [9]. Simple energy devices and power staplers used routinely in surgical practice may be considered as "intelligent" devices, in fact, they use algorithms to calculate hundreds of thousands of data points per second to determine the optimal coagulation velocity without movement or gesture of the surgeon, or they are provided of sensors that block the stapling action if the tissue is too thick or not thick enough, without interaction with the surgeon.…”

Section: Artificial Intelligence For Surgery: Enthusiasm or Disillusi...mentioning

confidence: 99%

Artificial intelligence in surgery: the emergency surgeon’s perspective (the ARIES project)

Simone

Chouillard

Gumbs

et al. 2022

Discov Health Systems

Self Cite

View full text Add to dashboard Cite

Artificial Intelligence (AI) has been developed and implemented in healthcare with the valuable potential to reduce health, social, and economic inequities, help actualize universal health coverage, and improve health outcomes on a global scale. The application of AI in emergency surgery settings could improve clinical practice and operating rooms management by promoting consistent, high-quality decision making while preserving the importance of bedside assessment and human intuition as well as respect for human rights and equitable surgical care, but ethical and legal issues are slowing down surgeons’ enthusiasm. Emergency surgeons are aware that prioritizing education, increasing the availability of high AI technologies for emergency and trauma surgery, and funding to support research projects that use AI to provide decision support in the operating room are crucial to create an emergency “intelligent” surgery.

show abstract

“…Newer collaborative robots that are handheld or do not use a console may also become useful in the surgeon’s armamentarium against CRLM and may actually permit a safer adoption of more automatic and autonomous actions in the operating room [ 58 , 59 , 60 , 61 ]. Modern-day liver surgeons will need expertise in open, laparoscopic and robotic-assisted techniques to offer the best personalized surgical care to their patients with CRLM.…”

Section: Future Directionsmentioning

confidence: 99%

Survival Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-2)

Gumbs

Croner

Lorenz

et al. 2022

Cancers

Self Cite

View full text Add to dashboard Cite

Introduction: Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-CRLM) was a propensity score matched (PSM) study that reported short-term outcomes of patients with CRLM who met the Milan criteria and underwent either open (OLR), laparoscopic (LLR) or robotic liver resection (RLR). This study, designated as SIMMILR-2, reports the long-term outcomes from that initial study, now referred to as SIMMILR-1. Methods: Data regarding neoadjuvant chemotherapeutic (NC) and neoadjuvant biological (NB) treatments received were collected, and Kaplan–Meier curves reporting the 5-year overall (OS) and recurrence-free survival (RFS) for OLR, LLR and RLR were created for patients who presented with synchronous lesions only, as there was insufficient follow-up for patients with metachronous lesions. Results: A total of 73% of patients received NC and 38% received NB in the OLR group compared to 70% and 28% in the LLR group, respectively (p = 0.5 and p = 0.08). A total of 82% of patients received NC and 40% received NB in the OLR group compared to 86% and 32% in the RLR group, respectively (p > 0.05). A total of 71% of patients received NC and 53% received NB in the LLR group compared to 71% and 47% in the RLR group, respectively (p > 0.05). OS at 5 years was 34.8% after OLR compared to 37.1% after LLR (p = 0.4), 34.3% after OLR compared to 46.9% after RLR (p = 0.4) and 30.3% after LLR compared to 46.9% after RLR (p = 0.9). RFS at 5 years was 12.1% after OLR compared to 20.7% after LLR (p = 0.6), 33.3% after OLR compared to 26.3% after RLR (p = 0.6) and 22.7% after LLR compared to 34.6% after RLR (p = 0.6). Conclusions: When comparing OLR, LLR and RLR, the OS and RFS were all similar after utilization of the Milan criteria and PSM. Biological agents tended to be utilized more in the OLR group when compared to the LLR group, suggesting that highly aggressive tumors are still managed through an open approach.

show abstract

White paper: definitions of artificial intelligence and autonomous actions in clinical surgery

Cited by 17 publications

References 0 publications

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Artificial intelligence in surgery: the emergency surgeon’s perspective (the ARIES project)

Survival Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-2)

Contact Info

Product

Resources

About