In Boston on October 27, 2023, a gathering of prominent surgeons came together to deliberate the groundbreaking impact of artificial intelligence (AI) on contemporary surgical techniques.
Dr. Brat (Left) and Dr. Tetteh (Right) discuss the intersection of surgery and artificial intelligence at the American College of Surgeons Clinical Congress. Image Credit: American College of Surgeons
The surgeons, recognized as trailblazers in integrating AI into their practices and exploring its potential applications, showcased how this technology is transforming patient care in the lead-up to surgery, during the procedure, and in the post-operative period.
This presentation occurred on Monday, October 23, as part of the American College of Surgeons (ACS) Clinical Congress 2023 in Boston, Massachusetts.
During the press conference, these experts underscored that AI is not merely a concept of the future but an immediate and impactful game-changer in the field of surgical care.
Artificial intelligence is poised to transform surgery in the same way that the use of anesthesia, the discovery of antibiotics, and the introduction of minimally invasive surgery have altered surgical care.
Danielle S. Walsh, MD, FACS, FAAP, Professor and Vice Chair of Surgery, Quality and Process Improvement, University of Kentucky
Walsh is also a specialist in pediatric surgery, who moderated the briefing.
The Promise of AI in Predictive Analysis
A pivotal topic of discussion revolved around the use of AI in forecasting adverse events and complications. Tyler J. Loftus, MD, FACS, who serves as an Assistant Professor of Surgery and holds the position of Research Director at the UF Intelligent Critical Care Center, University of Florida, and specializes in trauma and acute care surgery, elucidated how machine learning models could play a crucial role in guiding postoperative care decisions.
That post-operative triage decision is important in the patient's care path. And we use machine learning to make recommendations for which patients ought to go to an intensive care unit and which patients should go to a hospital floor.
Danielle S. Walsh, MD, FACS, FAAP, Professor and Vice Chair of Surgery, Quality and Process Improvement, University of Kentucky
Enhancing Decision-Making in High-Pressure Situations
Rachael A. Callcut, MD, FACS, who also holds the position of associate dean for data science and innovation at the University of California, Davis, School of Medicine and specializes in trauma surgery, addressed the utilization of AI in demanding, high-pressure surgical settings.
Decision-making is extremely complex for providers, where a tremendous amount of data comes at them that they can't synthesize all in real time. So, we developed technology in my lab that allows people to leverage the power of AI to make those decisions safer, timelier, and ultimately be able to export that expert knowledge to places that perhaps don't have people who are as experienced in the conditions in which they’re caring for.
Danielle S. Walsh, MD, FACS, FAAP, Professor and Vice Chair of Surgery, Quality and Process Improvement, University of Kentucky
AI’s Role in Surgical Precision
Dr. Walsh offered a concrete illustration of how AI technology is enhancing the safety of surgical procedures.
“When we take out a gallbladder, the gallbladder has a branch, kind of like a branch on a tree. There’s one branch that goes over the gallbladder, and out of all the different branches, you have to find exactly the right one,” explained Dr Walsh.
Walsh added, “One of the mistakes that can happen in surgery is somebody cuts the wrong branch. And if you were a surgeon in the operating room about to cut the wrong one, you might get a red flashing signal warning you are about to cut the wrong structure.”
Human Aspect Remains Crucial in AI Integration
But amid these technological advancements, the panelists underscored the indispensable role of the human touch in healthcare.
“While AI will change everything in surgery, it won’t impact the things that matter most, like the patient-physician connection. We will still need to moderate these human elements,” stated Hassan A. Tetteh, MD, MBA, FACS, FACHE, Associate Professor of surgery at the Uniformed Services University of the Health Sciences, Inova Fairfax Hospital surgeon, a specialist in thoracic surgery.
Tailoring AI to Individual Patient Care
The conversation also delved into AI’s capacity to individualize patient care. Dr. Loftus provided further details on how AI can aid patients confronting intricate surgical choices by delivering accurate predictions of outcomes and comprehending patient preferences, thereby offering customized recommendations.
“When artificial intelligence automates routine tasks, then the doctors and nurses can focus on and attend to deeper, more important aspects of patient care and leveraging the wisdom of experience plus intuition,” added Tetteh, indicating that AI’s role is supportive, thereby improving the capacity for human connection in patient care.
Navigating Potential Liabilities
As new technology emerges, it brings forth fresh responsibilities and potential legal obligations.
Christopher J. Tignanelli, MD, FACS, who serves as an Associate Professor of surgery at the University of Minnesota Medical School and specializes in critical care and acute care surgery, examined the legal considerations affecting various parties, including physicians, healthcare institutions, and AI developers or manufacturers.
Tignanelli emphasized potential situations in which these entities could encounter liability concerns, underscoring the significance of establishing standardized procedures and gaining a comprehensive grasp of the legal environment as AI integration becomes increasingly widespread.
Combining Human Insights With AI
Gabriel A. Brat, MD, MPH, FACS, who holds the position of assistant professor of surgery at Beth Israel Deaconess Medical Center and serves as an instructor in biomedical informatics at Harvard Medical School, specializing in trauma and critical care, underscores the mutually beneficial relationship between surgeons’ intuition and AI algorithms.
“If you take the surgeon’s intuition about what's happened to the patient and roll that in with the algorithms that have already been built to predict postoperative complications, you get better performance,” explained Brat.
Augmenting Surgical Expertise: The Supportive Role Of AI
Jennifer A. Eckhoff, MD, postdoctoral research fellow in surgery, Massachusetts General Hospital commented that “the ultimate goal for AI would be to augment and improve and assist surgeons rather than replacing them.”
Better Surgical Care through Artificial Intelligence
Surgeons at the forefront of the use of artificial intelligence (AI) to improve surgical care discuss the potential uses and ability of AI to predict adverse events and prevent complications in the preoperative, intraoperative, and postoperative settings. Video Credit: American College of Surgeons.