Cizmic Amila, Mitra Anuja T, Preukschas Anas A, Kemper Marius, Melling Nathaniel T, Mann Oliver, Markar Sheraz, Hackert Thilo, Nickel Felix
Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Department of Surgery & Cancer, Imperial College, London, UK.
Surg Endosc. 2025 May;39(5):2774-2783. doi: 10.1007/s00464-025-11685-6. Epub 2025 Mar 31.
Robotic-assisted minimally invasive esophagectomy (RAMIE) is a complex surgical procedure for treating esophageal cancer. Artificial intelligence (AI) is an uprising technology with increasing applications in the surgical field. This scoping review aimed to assess the current AI applications in RAMIE, with a focus on intraoperative video analysis.
To identify all articles utilizing AI in RAMIE, a comprehensive literature search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis for scoping reviews of Medline and Embase databases and the Cochrane Library. Two independent reviewers assessed articles for quality and inclusion.
One hundred and seventeen articles were identified, of which four were included in the final analysis. Results demonstrated that the main AI applications in RAMIE were intraoperative video assessment and the evaluation of surgical technical skills to evaluate surgical performance. AI was also used for surgical phase recognition to support clinical decision-making through intraoperative guidance and identify key anatomical landmarks. Various deep-learning networks were used to generate AI models, and there was a strong emphasis on using high-quality standardized video frames.
The use of AI in RAMIE, especially in intraoperative video analysis and surgical phase recognition, is still a relatively new field that should be further explored. The advantages of using AI algorithms to evaluate intraoperative videos in an automated manner may be harnessed to improve technical performance and intraoperative decision-making, achieve a higher quality of surgery, and improve postoperative outcomes.
机器人辅助微创食管切除术（RAMIE）是一种用于治疗食管癌的复杂外科手术。人工智能（AI）是一项正在兴起的技术，在外科领域的应用日益增加。本综述旨在评估当前AI在RAMIE中的应用，重点是术中视频分析。
为了识别所有在RAMIE中使用AI的文章，我们按照系统评价和Meta分析的首选报告项目，对Medline和Embase数据库以及Cochrane图书馆进行了全面的文献检索，以进行范围综述。两名独立的评审员对文章的质量和纳入情况进行了评估。
共识别出117篇文章，其中4篇纳入最终分析。结果表明，AI在RAMIE中的主要应用是术中视频评估和手术技术技能评估以评价手术表现。AI还用于手术阶段识别，通过术中指导支持临床决策并识别关键解剖标志。使用了各种深度学习网络来生成AI模型，并且非常强调使用高质量的标准化视频帧。
AI在RAMIE中的应用，特别是在术中视频分析和手术阶段识别方面，仍然是一个相对较新的领域，有待进一步探索。利用AI算法以自动化方式评估术中视频的优势，可能有助于提高技术性能和术中决策，实现更高质量的手术，并改善术后结果。
