[Application of artificial intelligence in gastric cancer surgery]

Artificial intelligence has rapidly advanced in recent years and is increasingly being incorporated into preoperative assessment, intraoperative assistance, and postoperative quality control in gastric cancer surgery. Radical gastrectomy is characterized by complex anatomical planes, frequent vascular variations, extensive lymph node dissection, and multiple intraoperative decision points. Artificial intelligence may provide surgeons with more intuitive, continuous, and quantifiable assistance through image recognition, multimodal prediction, three-dimensional navigation, and surgical video analysis. This review summarizes recent progress and potential clinical value of artificial intelligence in gastric cancer surgery from four aspects: anatomical recognition, metastasis risk assessment and intraoperative staging assistance, surgical navigation and decision support, and surgical quality control. Current studies suggest that artificial intelligence can help identify the pancreas, perigastric vessels, loose connective tissue, peritoneal metastases, surgical phases, and instrument movements. It may also contribute to risk stratification, preoperative planning, intraoperative warning, surgical training, and standardized quality assessment. However, clinical translation remains limited by insufficient high-quality annotated data, limited cross-center robustness, inadequate validation in real-world operative settings, and unresolved ethical and responsibility issues. Future multicenter prospective studies are needed to determine whether artificial intelligence can reliably improve surgical quality, oncological safety, and patient outcomes.