Editing AI in Surgery (section)

== <span style="color: #FFFFFF;">Understanding</span> ==
Surgical AI operates in three time domains: '''preoperative''' (planning and risk prediction), '''intraoperative''' (real-time guidance and safety), and '''postoperative''' (complication detection and outcomes).

'''Preoperative AI''': Risk models trained on surgical outcome data (NSQIP database: 6M+ surgical cases) predict complication probability — pneumonia, wound infection, VTE, 30-day mortality — from patient demographics, comorbidities, and procedure type. Surgeons and patients can use these to make informed decisions about surgical risk vs. benefit. AI also helps plan complex surgeries: automatic segmentation of CT/MRI defines anatomy, and virtual surgery simulations plan the safest operative approach.

'''Intraoperative phase recognition''': Laparoscopic cameras create a continuous video stream of the surgical field. CNNs and transformers trained on annotated surgical videos can classify surgical phases (preparation, dissection, clipping, cutting) and detect specific events (bleeding, instrument exchange). This enables: automatic operating room documentation, trainee guidance, context-sensitive decision support, and safety alerts (e.g., alerting when approaching a critical structure).

'''Critical View of Safety (CVS) AI''': In laparoscopic cholecystectomy, bile duct injury is a catastrophic complication. CVS is the standard safety criterion ensuring correct identification of the cystic duct. AI systems (Shoichi Kimura's group at Osaka; multiple startups) assess CVS from laparoscopic video, alerting surgeons when CVS has not been achieved before clipping. This targets one of the highest-impact surgical safety problems.

'''The Human-Robot Continuum''': Current surgical robots are master-slave systems — the surgeon controls every movement. Semi-autonomous systems (STAR robot for bowel anastomosis; Smart Tissue Autonomous Robot) demonstrate specific autonomous surgical subtasks. Full surgical autonomy is a long-term research goal, not a near-term reality.
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