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Should AI assist in surgical decision-making?


Mass Communication Specialist 2n

The first and second leading causes of death in the United States are heart disease and cancer. The third is now coronavirus. Know what’s next?

Astoundingly, the answer is preventable medical errors. Surgical errors in particular account for 26% of these deaths and cost somewhere north of $36 billion in the U.S. I did a double take when I read those stats while reporting this story. Some of the most common laparoscopic procedures, things like colectomies, hysterectomies, and gastrectomies result in an astounding number of preventable deaths.

Fully automated surgeries performed by robots is still a ways off. In the meantime, developers are trying to beat those grim numbers by harnessing the best of human decision making and coupling it with truly exceptional technology tools designed to assist surgeons. Artificial intelligence and machine learning are often touted as solutions for call centers and to provide intelligent insights to companies that have reams of data that needs to be processed, but leveraging AI/ML to better medical outcomes could be one of the transformative technologies of our time.

“Surgical decision-making is dominated by hypothetical-deductive reasoning, individual judgment, and heuristics,” write the authors of a recent JAMA Surgery paper called Artificial Intelligence and Surgical Decision-making. “These factors can lead to bias, error, and preventable harm. Traditional predictive analytics and clinical decision-support systems are intended to augment surgical decision-making, but their clinical utility is compromised by time-consuming manual data management and suboptimal accuracy.”

The paper’s authors propose AI as an effective augmentation tool to enhance in situ surgical decision making. We’re already seeing the first examples of this come to market. For example, a company called Activ Surgical, a digital surgery company focused on improving patient outcomes, recently debuted its ActivEdge platform, an AI/ML platform designed to provide critical real-time intelligence and visualization to surgeons. The platform and its associated products will be initially available in the U.S. market, with plans to commercialize globally in 2021. 

“The future of surgery is collaborative, with human judgment and wisdom augmented by robotics precision,” said Todd Usen, CEO, Activ Surgical. “With nearly 400,000 deaths in the U.S. every year due to avoidable medical errors, our surgical intelligence platform is designed to dramatically improve outcomes, safety and accessibility by arming surgeons with real-time information to make better informed decisions. We look forward to empowering global access to best-in-class surgery, regardless of location, saving millions of lives in the process.”  

Activ Surgical’s product portfolio, built on its Active Edge platform, includes hardware agnostic imaging software and computer-driven guidance systems, both for scopes and robots, to improve situational awareness and real-time imaging during surgical procedures and enable safe tissue access.

“Innovation in the surgical vision category is long overdue; the most commonly employed surgical imaging process, ICG, uses fluorescent dye invented more than 70 years ago and does not offer real-time, objective physiologic information to surgeons when they critically need it during procedures,” said Dr. Peter Kim, co-founder and chief science officer, Activ Surgical. “Activ Surgical is designed to empower surgeons to make better informed decisions by offering real-time intelligence and visualization to dramatically reduce medical complications and surgical errors.”

Activ Surgical’s product portfolio, built on its Active Edge platform, includes hardware agnostic imaging software and computer-driven guidance systems, both for scopes and robots, which improve situational awareness and real-time imaging during surgical procedures and enable safe tissue access.

Surgery certainly remains a human craft. But in the near future it’s realistic to envision many common surgeries aided by robotic and AI tools that help drive down the number of preventable deaths due to medical errors.