Remote detection of the critical view of safety in pediatric laparoscopic cholecystectomy using artifitial

Sean Exequiel Olivieri1,2, Santiago Darrigran3, Enrique Petracchi1

  • 1General Surgery, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina.

PubMed

Insights

Remote artificial intelligence (AI) successfully detected the critical view of safety (CVS) during pediatric laparoscopic cholecystectomy (LC). This AI-assisted approach proved feasible, safe, and consistent with expert surgeon evaluations, enhancing surgical safety in children.

Area of Science:

  • Pediatric surgery
  • Surgical safety
  • Artificial intelligence in medicine

Background:

  • Laparoscopic cholecystectomy (LC) is common in children, but bile duct injury is a serious risk.
  • The critical view of safety (CVS) reduces this risk, yet its identification is subjective.
  • Artificial intelligence (AI) shows promise for CVS detection in adults but hasn't been applied in pediatrics.

Purpose of the Study:

  • To evaluate the feasibility and accuracy of remote AI-assisted CVS detection in pediatric LC.
  • To assess the consistency of AI-driven CVS identification with expert surgical judgment.
  • To explore the potential of AI to reduce subjectivity and improve access to advanced surgical tools in pediatric procedures.

Main Methods:

  • A prospective, observational study tested an AI algorithm trained on adult LC cases in 50 pediatric patients.
  • Surgeries were transmitted in real-time; the AI processed images to identify CVS structures.
  • Two blinded expert surgeons independently assessed CVS presence, comparing their findings with the AI's.

Main Results:

  • The study included 50 pediatric patients (mean BMI 29.3±5.8).
  • The AI fully detected CVS in 37 cases and partially in 13.
  • There was 100% agreement between the AI and expert surgeons' assessments, with no reported postoperative complications.

Conclusions:

  • Remote AI-assisted CVS detection is feasible and safe in pediatric LC.
  • The AI's performance was consistent with expert surgical evaluations.
  • This technology holds potential for enhancing surgical safety and reducing subjectivity in pediatric procedures.
Abstract

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