From Scalpels to Algorithms: The Risk of Dependence on Artificial Intelligence in Surgery

Artificial Intelligence (AI) is transforming surgery, advancing robotic-assisted procedures, preoperative risk prediction, and intraoperative decision-making. However, increasing reliance on AI raises concerns, particularly regarding the potential deskilling of surgeons and overdependence on algorithmic recommendations. This over-reliance risks diminishing surgeons' skills, increasing surgical errors, and undermining their decision-making autonomy. The "black-box" nature of many AI systems also presents ethical challenges, as surgeons may feel pressured to follow AI-driven recommendations without fully understanding the underlying logic. Additionally, AI biases from inadequate datasets can result in misdiagnoses and worsen healthcare disparities. While AI offers immense promise, a cautious approach is vital to prevent overdependence. Ensuring that AI enhances rather than replaces human skills in surgery is critical to maintaining patient safety. Ongoing research, ethical considerations, and robust legal frameworks are essential for guiding AI's integration into surgical practice. Surgeons must receive comprehensive training to incorporate AI into their work without compromising clinical judgment. This letter emphasizes the need for clear guidelines, thorough surgeon training, and transparent AI systems to address the risks associated with AI dependence. By taking these steps, healthcare systems can harness the benefits of AI while preserving the essential human aspects of surgical care.