Evidence map›Paper›PMID 41099978›Full record

SynthesisJournal of robotic surgery2025

Application of artificial intelligence in esophageal surgery: a systematic review.

Janosch Kröger, Nicolas Jorek, Alexander Seitel, Leon Mayer, Gabriel A Salg, Nerma Crnovrsanin, Frank Pianka, Thomas Pausch, Lena Maier-Hein, Christoph Michalski and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Janosch KrögerDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Nicolas JorekDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany. Nicolas.Jorek@med.uni-heidelberg.de.
Alexander SeitelGerman Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany.
Leon MayerGerman Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany.
Gabriel A SalgDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Nerma CrnovrsaninDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Frank PiankaDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Thomas PauschDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Lena Maier-HeinDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Christoph MichalskiDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Henrik NienhüserDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The aim of this systematic review was to summarize and analyze the available literature on the application of artificial intelligence systems in esophageal surgery, focusing on anatomy recognition, instrument detection, and surgical phase recognition. Esophageal cancer poses a significant global health challenge, ranking as the seventh most common cancer worldwide. Esophagectomy is the only curative treatment for non-metastatic esophageal cancer. While the introduction of minimally invasive esophagectomy and later robot-assisted minimally invasive esophagectomy significantly improved surgical precision and patient outcome, this development promoted a transition to increasing digitalization and video processing. Subsequently facilitating the integration of artificial intelligence is a promising tool in the enhancement of esophageal surgery. A systematic search was conducted following the PRISMA guidelines in the Medline and Web of Science databases. Studies published between January 2019 and June 2025 published in English and without restrictions to study type were included. Inclusion criteria focused on artificial intelligence-based anatomy recognition, instrument recognition, and phase recognition in esophageal surgery. Studies addressing preoperative and postoperative risk prediction or artificial intelligence applications not directly related to the surgical procedure were excluded. The systematic literature search yielded 7063 results. After screening, we identified six studies examining artificial intelligence applications in esophagectomy focusing on anatomy, instrument, and phase recognition. Artificial intelligence can be a useful tool-especially for intraoperative anatomy recognition-reaching detection rates comparable to trained surgeons in real time as seen in one study, reaching a Dice coefficient of 0.58, which was close to that of an expert esophageal surgeon (0.62) and significantly higher than the general surgeon (0.47, p= 0.0019). Due to the heterogeneity of study aims, utilized algorithms and outcome measures direct comparison between studies was not feasible. Artificial intelligence has demonstrated significant potential in enhancing esophageal surgery by improving anatomical recognition and optimizing surgical workflow. Despite these advancements, challenges remain in standardizing datasets, refinement of annotation methodologies, and seamless integration into real-time surgical navigation systems. To ensure clinical applicability, future research should focus on large-scale validation and prospective clinical trials to establish artificial intelligence's clinical utility and safety in minimally invasive esophagectomy.

Indexed as

Artificial IntelligenceEsophageal NeoplasmsEsophagectomyEsophagusRobotic Surgical ProceduresHumansArtificial intelligenceEsophageal surgeryMachine learningMinimally invasive surgery

Identifiers

PMID41099978
PMCPMC12532729

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.