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Implementation of artificial intelligence-based computer vision model in laparoscopic appendectomy: validation,

Danit Dayan1, Nadav Dvir2, Haneen Agbariya2

  • 1Division of General Surgery, Affiliated to Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6, Weizman St., 6423906, Tel Aviv-Yafo, Israel. danitd.75@gmail.com.

Surgical Endoscopy
|April 25, 2024
PubMed
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An AI model accurately grades laparoscopic appendectomy complexity and safety adherence, predicting operative time but not postoperative outcomes. This technology enhances surgical assessment and efficiency in general surgery.

Area of Science:

  • Artificial Intelligence in Surgery
  • Computer Vision Applications
  • Surgical Workflow Analysis

Background:

  • The application of artificial intelligence (AI) in general surgery is rapidly advancing.
  • This study presents the real-world implementation of an AI-based computer-vision model for laparoscopic appendectomy (LA).

Purpose of the Study:

  • To evaluate the accuracy of an AI model in grading surgical complexity and adherence to safety protocols during LA.
  • To assess the clinical correlation between AI-driven assessments and patient outcomes.

Main Methods:

  • A retrospective analysis of 499 laparoscopic appendectomy videos using the 'Surgical Intelligence Platform'.
  • Comparison of AI-generated annotations with manual assessments by two expert surgeons.
  • Correlation of complexity grades with intraoperative and postoperative outcomes using patient data from 365 cases.
Keywords:
AppendectomyArtificial intelligenceComplexityComputer visionLaparoscopySafety

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Main Results:

  • The AI model demonstrated high agreement with expert surgeons for complexity grading (kappa 0.86) and full safety adherence (kappa 0.88).
  • Higher complexity grades correlated with longer operative times, increased intraoperative events, and longer hospital stays.
  • No significant correlation was found between complexity grade and postoperative complications, mortality, or readmissions.

Conclusions:

  • The AI model accurately assesses complexity and safety in laparoscopic appendectomy.
  • The AI system can predict intraoperative duration and course but shows no correlation with postoperative outcomes.
  • Further research is warranted to explore the full clinical utility of AI in surgical procedures.