ArticleSurgical endoscopy2024
Implementation of artificial intelligence-based computer vision model in laparoscopic appendectomy: validation, reliability, and clinical correlation.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Artificial intelligence assessment of Parkland's grading scale in laparoscopic cholecystectomy: a step toward real-world outcome prediction.Updates in surgery · 2026Article
- AI-based disease severity grading predicts complications in laparoscopic appendectomy.Surgical endoscopy · 2026Article
- AI-based computer vision as an adjunct tool for CVS documentation in laparoscopic cholecystectomy.Surgical endoscopy · 2026Article
- Impact of body mass index on perioperative outcomes and short-term recovery profiles of single-incision laparoscopic appendectomy: a propensity score-matched analysis.Frontiers in medicine · 2026Article
- Artificial Intelligence in Gastrointestinal Surgery: A Systematic Review of Its Role in Laparoscopic and Robotic Surgery.Journal of personalized medicine · 2025Review
- A Systematic Integration of Artificial Intelligence Models in Appendicitis Management: A Comprehensive Review.Diagnostics (Basel, Switzerland) · 2025Review
- Exploring the Role of Artificial Intelligence (AI)-Driven Training in Laparoscopic Suturing: A Systematic Review of Skills Mastery, Retention, and Clinical Performance in Surgical Education.Healthcare (Basel, Switzerland) · 2025Review
- Using artificial intelligence to evaluate adherence to best practices in one anastomosis gastric bypass: first steps in a real-world setting.Surgical endoscopy · 2025Article
- Artificial Intelligence in Surgery: A Systematic Review of Use and Validation.Journal of clinical medicine · 2024Review
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Authors and funding
4 authors.
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Abstract
backgroundApplication of artificial intelligence (AI) in general surgery is evolving. Real-world implementation of an AI-based computer-vision model in laparoscopic appendectomy (LA) is presented. We aimed to evaluate (1) its accuracy in complexity grading and safety adherence, (2) clinical correlation to outcomes.
methodsA retrospective single-center study of 499 consecutive LA videos, captured and analyzed by 'Surgical Intelligence Platform,' Theator Inc. (9/2020-5/2022). Two expert surgeons viewed all videos and manually graded complexity and safety adherence. Automated annotations were compared to surgeons' assessments. Inter-surgeons' agreements were measured. Since 7/2021 videos were linked to patients' admission numbers. Data retrieval from medical records was performed (n = 365). Outcomes were compared between high and low complexity grades.
resultsLow and high complexity grades comprised 74.8 and 25.2% of 499 videos. Surgeons' agreements were high (76.9-94.4%, kappa 0.77/0.91; p < 0.001) for all annotated complexity grades. Surgeons' agreements were also high (96.0-99.8%, kappa 0.78/0.87; p < 0.001) for full safety adherence, whereas agreement was moderate in partial safety adherence and none (32.8-58.8%). Inter-surgeons' agreements were high for complexity grading (kappa 0.86, p < 0.001) and safety adherence (kappa 0.88, p < 0.001). Comparing high to low grade complexity, preoperative clinical features were similar, except larger appendix diameter on imaging (13.4 ± 4.4 vs. 10.5 ± 3.0 mm, p < 0.001). Intraoperative outcomes were significantly higher (p < 0.001), including time to achieve critical view of safety (29.6, IQR 19.1-41.6 vs. 13.7, IQR 8.5-21.1 min), operative duration (45.3, IQR 37.7-65.2 vs. 25.0, IQR 18.3-32.7 min), and intraoperative events (39.4% vs. 5.9%). Postoperative outcomes (7.4% vs. 9.2%) including surgical complications, mortality, and readmissions were comparable (p = 0.6), except length of stay (4, IQR 2-5.5 vs. 1, IQR 1-2 days; p < 0.001).
conclusionThe model accurately assesses complexity grading and full safety achievement. It can serve to predict operative time and intraoperative course, whereas no clinical correlation was found regarding postoperative outcomes. Further studies are needed.
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