Mp07-04 Initial Experience With a Fully Integrated Artificial Intelligence Platform During Minimally Invasive Surgery

You have accessJournal of UrologySurgical Technology & Simulation: Artificial Intelligence I (MP07)1 May 2024MP07-04 INITIAL EXPERIENCE WITH A FULLY INTEGRATED ARTIFICIAL INTELLIGENCE PLATFORM DURING MINIMALLY INVASIVE SURGERY Abhinav Khanna, Stephen A. Boorjian, Igor Frank, Paras Shah, Vidit Sharma, R. Houston Thompson, Aaron Potretzke, George Chow, Adam Miller, Ross Avant, Daniel Elliott, Derek Lomas, J. Nicholas Warner, Kevin Koo, Meghan Cooper, Tobias Kohler, Lance Mynderse, and Matthew Tollefson Abhinav KhannaAbhinav Khanna , Stephen A. BoorjianStephen A. Boorjian , Igor FrankIgor Frank , Paras ShahParas Shah , Vidit SharmaVidit Sharma , R. Houston ThompsonR. Houston Thompson , Aaron PotretzkeAaron Potretzke , George ChowGeorge Chow , Adam MillerAdam Miller , Ross AvantRoss Avant , Daniel ElliottDaniel Elliott , Derek LomasDerek Lomas , J. Nicholas WarnerJ. Nicholas Warner , Kevin KooKevin Koo , Meghan CooperMeghan Cooper , Tobias KohlerTobias Kohler , Lance MynderseLance Mynderse , and Matthew TollefsonMatthew Tollefson View All Author Informationhttps://doi.org/10.1097/01.JU.0001008728.41882.d7.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recent advances in computer vision have enabled artificial intelligence (AI) evaluation of surgical video at a scale not previously feasible. Applying AI video analysis to real-world practice has potential to unearth new insights into surgery. We report our experience with an AI platform that is fully integrated into our urology practice. METHODS: Video from endoscopic, laparoscopic, and robotic surgeries performed at our tertiary academic center were uploaded into a secure location on the Mayo Clinic cloud server. Videos were analyzed in real-time using a novel AI computer vision platform (Theator, Inc.). Each surgical step was automatically detected by individualized AI algorithms tailored to each surgery type. Key safety events, such as "critical views of safety", preservation of key anatomic structures, and safety maneuvers were automatically annotated. Adverse events, including hemorrhage, tumor disruption, and vascular injury were identified. All AI-generated insights were annotated directly onto surgical video timelines, and results of AI analysis were available on mobile and desktop apps in real-time. RESULTS: From December 2021-September 2023, a total of 1388 surgeries were performed by 18 individual surgeons with real-time AI analysis. This included 766 radical prostatectomy (median video duration 156 IQR 112-197 minutes), 395 endoscopic BPH procedures (49 25-80 minutes), 132 partial nephrectomy (122 92-184 minutes), and 29 transurethral bladder tumor resection (31 23-77 minutes). Insights offered by AI video analysis include breakdown of full-length surgeries into distinct labeled steps, benchmarking efficiency of individual surgical steps across surgeons, and cataloging trends in surgical step duration and safety milestones over time (Figure 1). CONCLUSIONS: To our knowledge, this represents the first report of comprehensive integration of a novel AI computer vision platform into real-world surgical practice in the United States. Future investigations should explore the relationship between AI-detected intra-operative events with clinical outcomes. AI video analysis has potential applications in surgical education, quality benchmarking, performance review, automated documentation, and surgeon decision-support, all of which warrant further study. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e105 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Abhinav Khanna More articles by this author Stephen A. Boorjian More articles by this author Igor Frank More articles by this author Paras Shah More articles by this author Vidit Sharma More articles by this author R. Houston Thompson More articles by this author Aaron Potretzke More articles by this author George Chow More articles by this author Adam Miller More articles by this author Ross Avant More articles by this author Daniel Elliott More articles by this author Derek Lomas More articles by this author J. Nicholas Warner More articles by this author Kevin Koo More articles by this author Meghan Cooper More articles by this author Tobias Kohler More articles by this author Lance Mynderse More articles by this author Matthew Tollefson More articles by this author Expand All Advertisement PDF downloadLoading ...