European Urology Today: June/July 2023

AI applications in laparoscopic optical systems Artificial intelligence enables surgeons to navigate complex anatomies with greater precision

Stryker employs AI algorithms in their optical systems to offer features like automated image processing, instrument tracking, and augmented reality guidance for laparoscopic procedures. Intuitive Surgical (da Vinci) utilise AI algorithms in its optical systems. These algorithms assist in advanced imaging, instrument tracking, and tissue recognition during robotic-assisted laparoscopic procedures. The Asensus Surgical System employs AI algorithms and machine vision technology to augment surgical procedures in object recognition, tissue identification, and tracking instruments and their movements. The adoption of AI algorithms in laparoscopic optical systems is a rapidly evolving field, and in the near future more companies will integrate AI algorithms in their laparoscopic optical systems. By leveraging AI algorithms to interpret real-time images, urologic surgeons will benefit from advanced guidance and improve the accuracy and effectiveness of their procedures. Noteworthily, AI algorithms as decision-support tools can provide valuable assistance, but do not replace the expertise and experience of urologists. Urologists remain in control of the procedures and use AI algorithms as aids to enhance their surgical skills. In summary, the integration of AI in urologic minimally invasive surgery optical systems holds immense promise, enabling surgeons to navigate complex anatomies with greater precision. AI and image guidance work together to enhance surgical precision, improve decision-making, and optimise patient outcomes.

Surgical workflow optimisation AI algorithms can analyse laparoscopic videos and recognise patterns in surgical workflows, such as instrument usage and movement patterns. This data can be also used to provide feedback to surgeons, optimise their technique, and potentially improve efficiency and patient outcomes. Leading manufacturers of endoscopy and laparoscopy equipment such as KARL STORZ, Olympus, Stryker, Medtronic, Intuitive Surgical, and Asensus Surgical employ AI algorithms in their products. “The adoption of AI algorithms in laparoscopic optical systems is a rapidly evolving field, and in the near future more companies will integrate AI algorithms in their laparoscopic optical systems.” KARL STORZ incorporates AI algorithms in optical systems to provide features such as automated image analysis, real-time tissue differentiation, and augmented reality visualisation during laparoscopic procedures. Olympus has utilised AI algorithms in endoscopes and laparoscopic optical systems to offer features such as automated image recognition, lesion detection, and enhanced image quality for laparoscopic visualisation. Medtronic integrated AI algorithms in laparoscopic optical systems to provide real-time image analysis, tissue characterisation, and advanced visualisation capabilities.

of these critical structures during laparoscopic operations. AI algorithms can also recognise surgical phases of laparoscopic operation videos spanning a range of complexities. These algorithms can suggest the optimal instrument or camera angle, provide warnings about potential complications, or assist in precise tissue manipulation and aid the surgeon in navigating complex anatomies and reducing the risk of accidental damage and complications. Machine learning (ML) algorithms can improve surgical outcomes also by augmenting the display with information such as tumour localisation during the operation. AI algorithms have been applied in characterising different types of tissue based on visual cues and can provide real-time feedback to surgeons by analysing the optical properties of tissue and helping them differentiate abnormal tissue and tumours. Image enhancement AI algorithms can enhance laparoscopic images by reducing noise, improving contrast, and optimising the overall quality of the visual data. This can lead to clearer and more informative images, aiding urologists in their decision-making process during the surgery. The last studies showed that augmented reality (AR) technology combined with AI algorithms can overlay important virtual information in real time onto laparoscopic images. This can provide surgeons with additional guidance, such as highlighting the location of critical structures or displaying preoperative imaging data on the laparoscopic view, improving surgical precision. AI implementations Tissue characterisation

Prof. Ali Gözen Dept. of Urology Medius Kliniken Ostfildern-Ruit (DE)

The intersection of urologic minimally invasive surgery and artificial intelligence (AI) has paved the way for a new era of surgical precision, efficiency, and in the end, improved patient outcomes. Current endoscopy optics rely on digital technology with high-resolution imaging sensors and bright LED backlight displays. In urologic laparoscopy, AI algorithms can be employed in conjunction with modern optical systems to enhance various aspects of the procedure. Several optical companies employ AI algorithms in laparoscopy to enhance their products and provide advanced imaging and analysis capabilities. The optical systems employing AI can assist surgeons with different image analyses before, during and after the surgery. One critical aspect of urologic minimally invasive surgery is the precise identification and preservation of important structures such as neurovascular bundles during radical prostatectomy. AI algorithms can analyse laparoscopic images in real-time and identify anatomical structures, such as nerves, blood vessels, and tumours. This will assist urologic surgeons in the accurate and efficient identification

EAU Section of Uro-Technology (ESUT)

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European Urology Today June/July 2023


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