Artificial intelligence in gynecology surgery: Current status, challenges, and future opportunities

Abstract

Women’s health is a crucial, complex, and multifaceted field, encompassing gynecological disorders, reproductive health issues, conditions influenced by hormonal differences, and serious diseases such as ovarian and cervical cancer. Gynecologic surgery is a critical component of this field, presenting unique challenges due to the variability of anatomical lesions and patient-specific requirements. In recent years, the rapid development of information technology, particularly artificial intelligence (AI), has provided numerous opportunities to advance gynecologic surgery in clinical practice, research, and education.[1] This editorial aims to present the current status of AI applications in gynecologic surgery, discuss the technical and clinical challenges, and outline future prospects in this field. Preoperative planning and simulation: Preoperative planning is a fundamental phase in gynecologic surgery, where accurate diagnosis, strategic planning, and patient-specific simulation can significantly influence surgical outcomes. One of the most important applications of AI in preoperative planning is the enhancement of imaging diagnostics.[2] By integrating AI models, traditional imaging modalities such as ultrasound, magnetic resonance imaging (MRI), and computerized tomography (CT) scans can provide more detailed anatomical and pathological information. Preoperative 3D radiological images enable precise surgical planning, while adjustable augmented reality (AR) models and deep learning collectively optimize robotic surgery.[3] The development of AI-supported 3D printing techniques can further enhance surgeons’ capabilities while minimizing the likelihood of surgical errors.[4] For example, a 3D-printed model derived from preoperative MRI can reveal anatomical depth, width, and surrounding structure involvement. This can guide the operation, allow for rehearsal, reduce surgical duration, increase precision, and decrease complications, such as determining the optimal excision path for patients with uterine fibroids. In benign tumor surgeries, the application of AI and robotic systems requires specific considerations, highlighting a distinct cost-benefit ratio compared to more complex or malignant cases. Therefore, the decision to employ AI and robotic systems in benign tumor surgeries must weigh the advantages against the economic implications, ensuring that resources are allocated effectively to maximize patient care. Intraoperative navigation and assistance: AI is increasingly revolutionizing the intraoperative phase of gynecologic surgery by providing surgeons with advanced tools to enhance visualization, streamline workflows, and improve patient safety. Robotic-assisted surgical systems have already demonstrated their value in gynecologic procedures such as hysterectomies, myomectomies, and gynecologic oncology surgeries. For example, AI-driven robotic platforms can help surgeons visualize critical structures like blood vessels, nerves, and reproductive organs more clearly.[5] AI also facilitates communication among surgical team members by integrating data from various sources, such as intraoperative imaging, patient monitors, and robotic systems.[6] This approach reduces the cognitive load on the surgical team, allowing them to focus on critical tasks and make decisions more efficiently. Moreover, AI can process intraoperative data to predict potential complications before they arise. In gynecologic surgery, this could mean identifying early signs of excessive bleeding, detecting subtle changes in patient vitals, or predicting the likelihood of injury to adjacent structures.[7] Postoperative recovery and management: The postoperative phase is crucial for optimal recovery, minimizing complications, and enhancing outcomes after gynecologic surgery. AI is revolutionizing postoperative care by enabling personalized follow-up, early complication detection, and data-driven decision-making. By integrating data from wearable devic