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The role of artificial intelligence in surgery

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Thanks to artificial intelligence, there is a world of data out there that can instantly respond to my curiosity and influence my decision-making. (Courtesy photo)
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Artificial intelligence is everywhere, which makes you wonder why so many politicians say and do dumb things. Alexa, Siri and Cortana can not only understand your music preferences and other wishes, but they can also listen to questions asked in the work environment. For me, that means the operating room — for you, the patient, it means your surgeon is not alone. Here’s why it’s so useful:

I encounter little surprises in every surgical procedure. Every person is different, and each tissue has its own characteristics — from the obvious tear patterns to the hidden degeneration within the tissue’s collagen structure.

The source of these differences may be in the patients’ sports habits. Are they a pro athlete or an out-of-shape desk-jockey? How much are they going to push the limits of a repair? Will they follow the post-operative rehabilitation program? Have they been repaired before and re-injured? The tissue differences can be obvious muscle sizes, the shape of the bones, the angle of the joints, the blood supply to the torn fragments and/or the unique locations of the ligament insertions.

To my mind, there are no “routine” or “standardized” cases. Each procedure has its own beauty and intrigue. Each can be performed better than the last.

Thanks to artificial intelligence, there is a world of data out there that can instantly respond to my curiosity and influence my decision-making.

The medical database version of IBM’s Watson — and similar knowledge repositories from Google, Apple and even Amazon — are now available at the tip of my tongue. These tools are called “voice agents.” They listen passively and are available to answer any question I may have. I might ask for a reminder of a patient’s surgical history, for the data on a specific type of meniscus tear or for a suggestion on how to remove a broken screw that resists the techniques I have used before.

While much of the information is accessible before I even enter the operating room, the surprises I encounter in surgery are still enormous. Why? Because there are wide variations in each patient’s tissues, where they insert, how they interact and how they are injured. No two people are exactly alike — yet the similarities are what permit us to aggregate this data into our AI’s voice agents.

Before, surgeons usually had to go it alone. Today, we are empowered with the world’s knowledge of each case, each technique’s outcome, and with the many surgical variations that have been tried. While my head may hold a career’s worth of knowledge, and my hands skilled by practice, I was but one individual. I am alone no more.

I believe that no surgeon of the near future will enter the operating room without his or her voice agent waiting in the ether. And you thought ether was just to put you to sleep.

Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco.

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