The use of Artificial Intelligence (AI) in surgery is driving a medical revolution where surgical errors are being reduced and patient outcomes improved by its ability to analyse recorded video data from thousands of past operations around the world.
earning is a heavy burden of risk for the surgeon and patient to carry. Yet, now imagine if it was possible to harness the surgical experience of thousands of surgeons around the world in a “collective surgical consciousness” that would help surgeons anticipate mistakes and make better decisions while operating.
That exciting scenario is made possible by AI, says Dr Ozanan Meireles, co-founder and director of the Surgical Artificial Intelligence and Innovation Laboratory at the Massachusetts General Hospital at Harvard Medical School, who spoke recently at the Royal College of Surgeons (RCSI) in Dublin.
The use of AI in surgery is a transformative moment in the history of surgery, Dr Meireles told his medical peers at the RCSI Johnson and Johnson Charter Meeting, which takes place each year to celebrate the granting of a Royal Charter to the RCSI in 1784.
“The first revolution was anaesthesia, followed by antiseptic techniques,” Dr Meireles said.
“Endoscopic procedure introduced the era of robots and minimally invasive surgery, and now artificial intelligence: the fourth surgical revolution.”
The surgical areas that are already seeing the benefits from AI are those that are relatively straightforward, minimally invasive, involving relatively few incisions.
AI has been successful in helping surgeons with the identification of polyps during colonoscopy procedures that require removal but has proved far less successful when it was tested as a potential tool to assist cardiac surgery.
The surgical community is looking at many areas where AI might help.
“We had great discussions at dinner yesterday about the use of AI on the battlefield,” Dr Meireles said.
“Imagine if while doing a procedure, the machine triggers tele-mentoring from an expert surgeon to help guide through a procedure.”
In Ireland, AI is being used at the Mater Hospital to better ‘see’ tumours in real time and provide surgeons with a far better chance of fully removing them.
A new AI technique has been developed by Professor Ronan Cahill, director of the UCD Centre for Precision Surgery at the Mater Hospital with Dr Jeffrey Dalli and IBM Research.
Prof Cahill is a specialist on colorectal cancer, which affects around 2,800 people per year in Ireland, with 900 deaths per annum. It is often the case that several operations are required to remove a patient’s colorectal cancer. The use of AI, a camera and dyes can help surgeons better ‘see’ cancer and remove it all first time.
“A few minutes is enough to determine if a lesion is cancerous,” Prof Cahill said.
“If it is there is no need to wait for a biopsy, we can remove it straight away. The best chance is to get the operation right first time – it’s the law of diminishing returns if you have to go back and operate again,” he added.
Leading surgeons like Dr Meireles and Prof Cahill expect that AI will be used in the next five to 10 years to greatly improve surgical outcomes for operations that are relatively straightforward and do require a huge number of incisions. This will reduce surgical errors, as the AI can flag potential surgical errors in real time.
The day when the accumulated knowledge of surgeons everywhere is available to surgeons through AI systems as they operate, no matter where that might be – even on a battlefield – is coming soon.
“Imagine the day we can do this?” Dr Meireles asked his medical peers at RCSI.
“The day we can actually use this collective consciousness to help us prevent a mistake.”