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    Online Exclusives

    The Future of AI and OR Medical Devices

    Bringing artificial intelligence to the operating room.

    The Future of AI and OR Medical Devices
    Touch Surgery Enterprise allows surgeons to seamlessly and securely upload, store, analyze, and share surgical videos.
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    Michael Hutton, Upper GI Specialist at Royal Cornwall Hospitals NHS Trust 06.30.21
    Surgical video can be a helpful tool for training and standardization, but in the past, the process of capturing and storing video was prohibitively complicated. Integrating artificial intelligence (AI) into medical devices enhances their usability and drives innovation.
     
    First, surgeons interested in recording surgical video need to remember to set up and start a recording, which can be a cumbersome additional process in the surgical theater. Next is the time-consuming practice of downloading, reviewing, and editing the video. Lastly, information security and privacy concerns emerge throughout, especially with respect to General Data Protection Regulation (GDPR) compliance. Storing files on loose USB drives or expensive solid-state drives (SSD) poses yet another barrier to streamlined and effective use of surgical video.
     
    The inconvenient and often unmanageable process of recording surgical video is a key example of the need for new medical devices. A cutting-edge device that solves a problem is only truly innovative if physicians or patients can use it effectively, and the Touch Surgery Enterprise system is such an innovation.
     
    AI for the OR
    Across disciplines, AI is improving how we work with medical devices. It has the potential to transform surgery by standardizing surgical processes, improving quality of care, and supporting training and research.
     
    Recording and reviewing surgical video, at present, is a time-consuming process that has significantly improved with the integration of AI. Surgeons using Touch Surgery Enterprise, a smart surgical video recorder, can record video in the operating room (OR) with one touch of a button. AI algorithms anonymize and analyze the video before it is uploaded to a clinician’s personal library, and videos are automatically split into phases according to critical steps in a procedure. This process allows clinicians to share their cases quickly and efficiently without compromising patient privacy. It also enhances the ability of clinicians to review these critical steps. For instance, if a complication arises from the surgery, video can be quickly and robustly reviewed through the platform in an open and transparent governance system. Ultimately, the transparency that surgical video offers is beneficial to excellent patient outcomes.
     
    AI technology unleashes the full power of surgical video for both experienced and trainee surgeons. If a picture is worth a thousand words, surgical video is worth ten thousand. Case notes may give some detail, but video objectively captures important details from a procedure, including the amount of time spent, the number of touches in a certain maneuver, and nuanced details of operating patterns. AI insights amplify the power of video by making it more efficient and easier to use.
     
    Using surgical video for training purposes means that surgeons can collaborate with trainees remotely or in-person before a procedure to review challenging components and reduce the stress of seeing a process for the first time in the surgical theater. Typically, when surgeons perform appendectomies for the first time, they operate in front of a group of peers and mentors. The ability to prepare by reviewing surgical video can help reduce a surgeon’s stress going into the procedure and help them focus on the task at hand. With video indexed by AI, trainees can easily ask questions about particular maneuvers, postures or processes after the procedure. AI simplifies the process of finding a particular part of a surgery without wasting time searching for the appropriate clip. An AI-powered library of surgical video also makes it easier to reference cases with abnormal anatomy or other unusual circumstances in preparation for surgery.
     
    Patient and Clinician Benefits
    The widespread use of AI-supported surgical video can increase standardization among surgeons. Without the ability to review procedure video, a surgeon may not be aware of their habits during a procedure, and video can help to reveal key differences in technique among professionals. For example, viewing post-procedure video could help a surgeon make their movements more concise and improve overall efficiency, and in the future, surgical video integrated with AI might even help identify surgeons whose operating patterns are changing due to their own health conditions.   
     
    Surgical video is a tool that can yield a new generation of surgeons informed by a standard of transparency and thoroughness that ultimately benefits the patient. Take, for example, a common procedure such as a routine laparoscopic cholecystectomy but with a large, unexpected right hepatic artery in Calot’s triangle. This now becomes a challenging, high-stakes procedure, as injuring the artery would compromise the patient’s liver. Seeing a video of this potential hazard beforehand would make surgeons feel confident and prepared to approach the potential danger in a safe and standard way, even if they don’t have that particular firsthand experience themselves.
     
    In addition, many patients are interested in seeing video from their own surgical procedures to better understand what happens during surgery. This tool helps surgeons explain procedures to patients. For example, when a surgeon is unable to complete a procedure as expected, the ability to review the video with the patient to explain the obstacle increases the patient’s understanding of their own health.
     
    The Future of AI
    AI is unlocking a new era in medical technology. It will remove the subjectivity and bias a human introduces when grading the difficulty of a procedure, and it will be an integral part of training robots to perform surgery. There will be only one type of physician in the future — 
    one that works with AI. Further down the line, AI will enable fully remote operations. A robust library of surgical video is central to the training of AI for these exciting new frontiers.
     
    AI enhances the utility of surgical video, and its integration into other medical devices can support more comprehensive training, more open patient-physician communication, and an improved standard of care. Integrating AI and the analytical power of computers with the expertise of medical device designers and surgeons is unlocking the future of healthcare for patients.
     

    Michael Hutton is an Upper GI Specialist at Royal Cornwall Hospitals NHS Trust in the United Kingdom.
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