AI in pediatric surgery: a narrative review

Artificial intelligence (AI) is transforming the medical field, including pediatric surgery, by enhancing diagnostic precision, surgical planning, intraoperative guidance, and postoperative care. Despite the increasing interest, a comprehensive understanding of AI's current applications and challenges in pediatric surgery is lacking. This narrative review aims to summarize current AI applications in pediatric surgery and evaluate their impact on clinical care, surgical training, and patient outcomes.

A literature review was conducted in January 2025 using PubMed and Web of Science. The search terms were "artificial intelligence" and "pediatric surgery", restricted to English-language articles published from 2015 to 2025. After excluding studies on adult populations and unrelated specialties, 46 articles were selected for analysis.

The reviewed literature demonstrates AI's utility across the pediatric surgical spectrum. Most prominently, AI enhances diagnostic accuracy for conditions like appendicitis, necrotizing enterocolitis (NEC), Hirschsprung's disease (HD) and biliary atresia. AI also supports surgical planning via three-dimensional (3D) modeling, augments intraoperative navigation and skill assessment, and improves postoperative care through complication prediction and pain evaluation. Furthermore, AI tools facilitate caregiver education and emotional support. Nevertheless, limitations remain, including pediatric data scarcity, variability in model reporting, and unresolved ethical and legal concerns.

AI holds great potential for transforming pediatric surgical care by improving accuracy, efficiency, and personalization. Future research should focus on generating robust pediatric datasets, validating tools in clinical settings, and integrating ethical frameworks. AI-human collaboration could reshape pediatric surgery and contribute meaningfully to patient care and policy development.