Educational Impact of Artificial Intelligence-Navigation Surgery on Anatomical Landmark Recognition in Medical...

We evaluated the educational impact of artificial intelligence (AI)-navigation surgery for medical students which provides real-time anatomical landmark recognition during laparoscopic cholecystectomy (LC).

Thirty fifth-year medical students were randomly assigned to three groups: surgeon-guided (n = 10), self-learning (n = 10), and AI-learning (n = 10). Each group annotated anatomical landmarks, extrahepatic bile duct (EHBD), cystic duct (CD), Rouvière's sulcus (RS), the base of liver segment 4 (S4), before and after training. The AI-learning group received real-time feedback using a deep learning segmentation model (HyperSeg). Learning outcomes were quantitatively assessed and compared to expert annotations using Dice coefficients, and post-study questionnaires were analyzed to evaluate understanding of anatomy and surgical procedures.

The mean Dice coefficients in the surgeon-guided (0.450 ± 0.025) and AI-learning groups (0.432 ± 0.038) were significantly higher in comparison to the self-learning group (0.351 ± 0.057, p = 0.00006). In an itemized analysis, significant improvements were observed in EHBD and RS recognition, but not in CD or S4 recognition. In the post-study questionnaire assessing anatomical understanding and the ability to comprehend the surgeon's perspective and intentions, the surgeon-guided group showed significantly better results in comparison to the self-learning group (p < 0.001 for each comparison). However, there was no significant difference between the AI-learning and self-learning groups.

AI has the potential to complement surgeon's guidance, reducing faculty burden while maintaining educational quality in surgical education.