AI in surgery: A double-edged scalpel?

By Dr. Priyom Bose, Ph.D.May 8 2023Reviewed by Benedette Cuffari, M.Sc.

Artificial intelligence (AI) can be defined as the application of computer algorithms that mirror or extend human cognitive processes. The role of AI in the world of medicine is rapidly advancing, as evident following the widespread use of  ChatGPT technology, an AI chatbot developed by OpenAI and released in November 2022

In surgery, AI could improve efficiency and results in surgical treatments; however, there are growing concerns that the general use of this technology could result in inappropriate therapeutic interventions. A recent study published in The American Surgeon discusses how AI can be integrated into surgery, as well as the ethical considerations around its use.

Study: Harvesting the Power of Artificial Intelligence for Surgery: Uses, Implications, and Ethical Considerations. Image Credit: Jirsak / Shutterstock.com

AI in surgery

AI can quickly and efficiently analyze vast amounts of data, as well as address the several challenges facing the current healthcare system. Modern healthcare generates large amounts of data which can aggregated and synthesized by AI to deliver targeted outputs useful for surgeons. These outputs could be from the initial consultation stage to post-operative management.

Given the potential ways in which AI can be integrated into surgery, it is not possible to fully describe the breadth of possibilities. Prior to surgery, AI algorithms could provide predictive analyses to aid in early disease detection, which could lead to faster interventions and, as a result, improve outcomes and prognosis.

Doctors could also use technology to study patients’ lab reports, scans, and other medical records to develop customized treatment plans at a more micro level. In the operating theater, AI technology could enhance decision-making by analyzing data from multiple sources in real-time and offering feedback to the surgeon. This could lead to improved decision-making and prevent adverse outcomes.

Following discharge from the hospital, AI could be used to evaluate data from patient monitoring systems to detect possible complications between post-operative visits. On a more routine basis, AI-based platforms could be established to be the first line of communication for patients regarding minor concerns or frequently asked questions. Overall, the use of AI in surgery could reduce the risk of complications, enhance recovery time, and improve the overall patient experience.

Challenges of using AI in surgery

Paralleling the use of web-based search engines, patients may similarly turn to AI-based applications for research and self-education. This issue has been raised following the advent of ChatGPT, which is immensely popular among medical professionals and the general public.

Owing to increased accessibility, there is a risk that ChatGPT could be severely misused. Concerns have been raised about the possibility to replace human expertise and prescribe unfounded medical recommendations.

Given the ease with which one can input a medical query and receive what appears to be a well-thought-out treatment plan, the public should be apprehensive of what could happen if this technology were to be misused. 

Patient privacy and data sharing concerns have also increased following the integration of AI into clinical practice. AI-based platforms rely on the availability of large volumes of medical information to provide optimal responses to questions.

Unauthorized access to protected healthcare databases could have severe consequences for both individuals and healthcare systems. Individuals might be reluctant to consent to the use of private data for training AI, as they may be unaware of the breadth of information that could be accessed by external systems.

The uncertainty surrounding data usage underlines the medico-legal aspects that should be considered when integrating AI in surgery.

Currently, the protocols and norms regulating the clinical operation of AI are inadequate. Therefore, AI could be used by practitioners unfamiliar with the technology, which could lead to medical errors and malpractice liability. It may also be difficult to ascertain whether the doctor, hospital, or developer of the AI tool is responsible for these erros.

How to reduce concerns around the use of AI in medicine

It could be useful for all assistance offered by AI-based systems to undergo a necessary secondary evaluation by a qualified medical professional. Likewise, the assistance should carry a disclaimer clearly stating the differences between surgeon-generated medical advice and AI.

To alleviate concerns about the privacy and security of patient data, anonymization protocols will need to be established and robust security measures developed for all databases. Patients should also be educated about the potential use of their data to mitigate concerns. It is also important that informed consent is obtained to ascertain whether patients endorse the use of AI.

As the quality and precision of AI-based systems continue to improve, complications stemming from AI-based systems are expected to be greatly reduced. It is clear that this technology will have an immense impact in the surgical space; however, key ethical considerations should be carefully considered.