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Accuracy of warm ischemia time measurement using a surgical intelligence software in partial nephrectomies: A
Archan Khandekar1, Joao G Porto1, Jean C Daher1
1Desai Sethi Urology Institute, Miller School of Medicine University of Miami Miami Florida USA.
BJUI Compass
|January 2, 2025
Summary
Surgical artificial intelligence (AI) software accurately measures warm ischemia times (WITs) during partial nephrectomies, outperforming surgeon reports. This AI technology shows promise for improving intraoperative documentation and surgical outcome research.
Area of Science:
- Urology
- Surgical Technology
- Artificial Intelligence in Medicine
Background:
- Partial nephrectomy is a complex procedure requiring precise management of warm ischemia time (WIT).
- Accurate WIT measurement is crucial for assessing renal function and surgical outcomes.
- Current methods of documenting WIT, relying on operative reports, may lack precision.
Purpose of the Study:
- To compare the accuracy of WITs derived by surgical artificial intelligence (AI) software against surgeon-documented times in partial nephrectomy.
- To evaluate the potential of AI-derived WITs in assessing postoperative renal function.
- To explore correlations between AI-derived WITs and other surgical parameters.
Main Methods:
- Surgical videos of partial nephrectomies (October 2023-April 2024) were analyzed using AI software with computer vision algorithms.
- Platform-derived WITs were compared to expert-reviewed ground truth and surgeon operative reports.
- Correlation analysis was performed between AI-derived WITs and postoperative creatinine levels from electronic health records.
Main Results:
- AI-derived WITs demonstrated high accuracy, with a mean difference of 8.3 seconds compared to ground truth.
- The difference for AI-derived WITs (8.3 s) was significantly smaller than for operative reports (2.45 min, p < 0.001).
- No significant correlation was found between AI-derived WIT and postoperative creatinine, but correlations with tumor size and RENAL score were observed.
Conclusions:
- Surgical AI platforms offer highly accurate WIT measurements during partial nephrectomies.
- AI-based WIT measurement enhances intraoperative documentation precision.
- Integrating AI data with EHRs holds potential for advancing surgical outcome research.
