Although AI has been making significant inroads across much of the healthcare sector, its impact on surgery has lagged behind. But according to one Harvard Medical School faculty member, AI is increasingly being picked up as a supplement to human surgical skills.
In a commentary, Liz Kwo, MD, notes that “although the potential of the surgeon-patient-computer relationship is a long way from being fully explored, the use of AI in surgery is already driving significant changes for doctors and patients alike.”
For example, in preoperative planning, deep learning algorithms have been used to boost image analysis techniques, including anatomical classification, detection segmentation and image registration.
Perhaps the biggest development Kwo describes is in AI assistance through surgical robotics.
“Designed to assist during operations with surgical instruments' manipulation and positioning, AI-driven surgical robots are computer-manipulated devices that allow surgeons to focus on the complex aspects of a surgery,” she explains. “Their use decreases surgeons' fluctuations during surgery and helps them improve their skills and perform better during interventions, hence obtaining superior patient outcomes and decreasing overall healthcare expenditures.”
In addition, surgical robots are helping identify critical insights and state-of-the-art practices by browsing through millions of data sets. For example, one tool consists of “a performance-guided laparoscopic AI robot that provides information back to surgeons, such as size of tissue, rather than requiring a physical measuring tape.”
In the area of specifically AI-assisted surgery, Kwo describes the interaction between humans and robots that enables human surgeons to operate surgical robots through touchless manipulation.
“This manipulation is possible through head or hand movements, through speech and voice recognition, or via the surgeon's gaze,” she explains. For example, surgeons’ head movements have been used to remotely control robotic laparoscopes. In one case, “(t)he motion of the laparoscope is simply and accurately controlled by the facial gestures of the surgeon, hence providing noninvasive and nonverbal cooperation between the human and the robot for various surgical procedures.”
In another example of AI-assisted surgery, the Maastricht University Medical Center in the Netherlands has used an AI-driven robot in a microsurgery intervention. “The surgical robot was used to suture blood vessels between 0.03 and 0.08 millimeters in a patient affected by lymphedema. This chronic condition is often a side effect that occurs during treatment of breast cancer that causes swelling as a result of built-up fluids.” The robot used in the procedure was manipulated by a human surgeon, but in what might be called an example of real teamwork, the surgical robot was also used to fix the trembles in the surgeon’s movements, ensuring the AI-driven device was properly conducting the procedure.
Surgeons create partnerships with scientists to capture, process and classify data across each phase of care to provide useful clinical context, Kwo observes. Despite an array of regulatory and legal hurdles still to be leapt, surgeons may soon be striking up similar partnerships with AI-driven robots.
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