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Machine Learning and Artificial Intelligence in Surgical Fields

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Abstract

Artificial intelligence (AI) and machine learning (ML) have the potential to improve multiple facets of medical practice, including diagnosis of disease, surgical training, clinical outcomes, and access to healthcare. There have been various applications of this technology to surgical fields. AI and ML have been used to evaluate a surgeon’s technical skill. These technologies can detect instrument motion, recognize patterns in video recordings, and track the physical motion, eye movements, and cognitive function of the surgeon. These modalities also aid in the advancement of robotic surgical training. The da Vinci Standard Surgical System developed a recording and playback system to help trainees receive tactical feedback to acquire more precision when operating. ML has shown promise in recognizing and classifying complex patterns on diagnostic images and within pathologic tissue analysis. This allows for more accurate and efficient diagnosis and treatment. Artificial neural networks are able to analyze sets of symptoms in conjunction with labs, imaging, and exam findings to determine the likelihood of a diagnosis or outcome. Telemedicine is another use of ML and AI that uses technology such as voice recognition to deliver health care remotely. Limitations include the need for large data sets to program computers to create the algorithms. There is also the potential for misclassification of data points that do not follow the typical patterns learned by the machine. As more applications of AI and ML are developed for the surgical field, further studies are needed to determine feasibility, efficacy, and cost.

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References

  1. LeCun Y, Bengio Y, Hinton G (2015) Deep learning. Nature. 521(7553):436–444. https://doi.org/10.1038/nature14539

    Article  CAS  PubMed  Google Scholar 

  2. Lundervold AS, Lundervold A (2018) An overview of deep learning in medical imaging focusing on MRI. Zeitschrift fur Medizinische Physik 29:102–127. https://doi.org/10.1016/j.zemedi.2018.11.002

    Article  PubMed  Google Scholar 

  3. Vaughn CJ, Kim E, O’Sullivan P, Huang E, Lin MYC, Wyles S et al (2016) Peer video review and feedback improve performance in basic surgical skills. Am J Surg 211(2):355–360. https://doi.org/10.1016/j.amjsurg.2015.08.034

    Article  PubMed  Google Scholar 

  4. Nakada SY, Hedican SP, Bishoff JT, Shichman SJ, Wolf JS Jr (2004) Expert videotape analysis and critiquing benefit laparoscopic skills training of urologists. JSLS. 8(2):183–186

    PubMed  PubMed Central  Google Scholar 

  5. Hashimoto DA, Rosman G, Witkowski ER, Stafford C, Navarette-Welton AJ, Rattner DW, Lillemoe KD, Rus DL, Meireles OR (2019) Computer vision analysis of intraoperative video: automated recognition of operative steps in laparoscopic sleeve gastrectomy. Annals of Surg 270:414–421. https://doi.org/10.1097/SLA.0000000000003460

    Article  Google Scholar 

  6. Vedula SS, Ishii M, Hager GD (2017) Objective assessment of surgical technical skill and competency in the operating room. Annu Rev Biomed Eng 19(1):301–325. https://doi.org/10.1146/annurev-bioeng-071516-044435

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Gomez ED, Aggarwal R, McMahan W, Bark K, Kuchenbecker KJ (2016) Objective assessment of robotic surgical skill using instrument contact vibrations. Surg Endosc 30:1419–1431. https://doi.org/10.1007/s00464-015-4346-z

    Article  PubMed  Google Scholar 

  8. Guru KA, Esfahani ET, Raza SJ, Bhat R, Wang K, Hammond Y, Wilding G, Peabody JO, Chowriappa AJ (2015) Cognitive skills assessment during robotic-assisted surgery: separating the wheat from the chaff. BJU Int 115(1):166–174. https://doi.org/10.1111/bju.12657

    Article  PubMed  Google Scholar 

  9. Hung AJ, Chen J, Gill IS (2018) Automated performance metrics and machine learning algorithms to measure surgeon performance and anticipate clinical outcomes in robotic surgery. JAMA Surg 153(8):770–771. https://doi.org/10.1001/jamasurg.2018.1512

    Article  PubMed  Google Scholar 

  10. French A, Lendvay TS, Sweet RM, Kowalewski TM (2017) Predicting surgical skill from the first N seconds of a task: value over task time using the isogony principle. Int Jour of Comp Assis Rad and Surg 12(7):1161–1170. https://doi.org/10.1007/s11548-017-1606-5

    Article  Google Scholar 

  11. Carpenter BT, Sundaram CP (2017) Training the next generation of surgeons in robotic surgery. Robot Surg 4:39–44. https://doi.org/10.2147/RSRR/S70552

    Article  PubMed  PubMed Central  Google Scholar 

  12. Jain M, Fry BT, Hess LW, Anger JT, Gewertz BL, Catchpole K (2016) Barriers to efficiency in robotic surgery: the resident effect. J Surg Res 205(2):296–304. https://doi.org/10.1016/j.jss.2016.06.092

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wiegmann DA, ElBardissi AW, Dearani JA, Daly RC, Sundt TM (2007) Disruptions in surgical flow and their relationship to surgical errors: an exploratory investigation. Surgery. 142(5):658–665. https://doi.org/10.1016/j.surg.2007.07.034

    Article  PubMed  Google Scholar 

  14. Sridhar AN, Briggs TP, Kelly JD, Nathan S (2017) Training in robotic surgery—an overview. Current Urology Reports.:18–18. https://doi.org/10.1007/s11934-017-0710-y

  15. Okamura AM (2009) Haptic feedback in robot-assisted minimally invasive surgery. Curr Opin Urol 19(1):102–107. https://doi.org/10.1097/MOU.0b013e32831a478c

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pandya A, Eslamian S, Ying H, Nokleby M, Reisner LA (2019) A robotic recording and playback platform for training surgeons and learning autonomous behaviors using the da Vinci Surgical system. Robotics 8(9). https://doi.org/10.3390/robotics8010009

  17. Wang S, Summers RM (2012) Machine learning and radiology. Med Image Anal 16(5):933–951. https://doi.org/10.1016/j.media.2012.02.005

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Bi WL, Hosny A, Schabath MB, Giger ML, Birkbak NJ, Mehrtash A et al (2019) Artificial intelligence in cancer imaging: clinical challenges and applications. CA A Cancer J Clin 69:127–157. https://doi.org/10.3322/caac.21552

    Article  Google Scholar 

  19. Park SY, Kim SM (2015) Acute appendicitis diagnosis using artificial neural networks. Technol Health Care 23(Suppl 2):S559–S565. https://doi.org/10.3233/THC-150994

    Article  PubMed  Google Scholar 

  20. Matsuki Y, Nakamura K, Watanabe H, Aoki T, Nakata H, Katsuragawa S, Doi K (2002) Usefulness of an artificial neural network for differentiating benign from malignant pulmonary nodules on high-resolution CT evaluation with receiver operating characteristic analysis. Am J Roentgenol 178:657–663. https://doi.org/10.2214/ajr.178.3.1780657

    Article  Google Scholar 

  21. Litjens G, Sanchez CI, Timofeeva N, Hermsen M, Nagtegaal I, Kovacs I et al (2016) Deep learning as a tool for increased accuracy and efficiency of histopathological diagnosis. Sci Rep 6:26286. https://doi.org/10.1038/srep26286

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Flodgren G, Rachas A, Farmer AJ, Inzitari M, Shepperd S (2015) Interactive telemedicine: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2015(9):CD002098. https://doi.org/10.1002/14651858.CD002098.pub2

    Article  PubMed Central  Google Scholar 

  23. Kahn JM, Rak KJ, Kuza CC, Ashcraft LE, Barnato AE, Fleck JC et al (2019) Determinants of intensive care unit telemedicine effectiveness. An ethnographic study. Am J Respir Crit Care Med 199(8):970–979. https://doi.org/10.1164/rccm.201802-0259OC

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lee H, Park JB, Choi SW, Yoon YE, Park HE, Lee SE, Lee SP, Kim HK, Cho HJ, Choi SY, Lee HY, Choi J, Lee YJ, Kim YJ, Cho GY, Choi J, Sohn DW (2017) Impact of a telehealth program with voice recognition technology in patients with chronic heart failure: feasibility study. JMIR Mhealth Uhealth 5(10):e127. https://doi.org/10.2196/mhealth.7058

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Melissa Egert or Chandru P. Sundaram.

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Egert, M., Steward, J.E. & Sundaram, C.P. Machine Learning and Artificial Intelligence in Surgical Fields. Indian J Surg Oncol 11, 573–577 (2020). https://doi.org/10.1007/s13193-020-01166-8

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