[Digital operating room-From dream to workflow]

The challenging transformation of medicine in the twenty-first century, involving robotics, artificial intelligence (AI) and the digitalization of daily work routines, is hampered by bureaucratic hurdles, a shortage of skilled workers and socioeconomic pressures within an aging healthcare system. This article provides an overview of current possibilities and applications of AI in the (peri)operative care of trauma patients. Even before surgeons enter the operating room, preoperative AI planning tools could increase efficiency in the future. Intraoperatively, navigation and robotics are already well-established and improve precision. In the future, ambient AI and digital twins can be expected to also link perioperative data as well as optimizing workflows and making decisions. The AI-supported surgical documentation increasingly relieves the workload for physicians but it still poses risks and interoperability issues. Key hurdles for AI in the operating room remain data heterogeneity, a lack of standardization and costs. It is also important, especially in the operating room, that the ethical responsibility for controlling (semi)autonomous systems remains with humans.