US surgeons are leveraging artificial intelligence (AI) to enhance patient selection for surgery, anticipate and prevent potential complications, and closely monitor postoperative recovery, all aimed at improving patient outcomes.
While AI applications like chatbots and search engines have garnered widespread attention, its potential in healthcare, particularly surgery, is immense.
The City of Hope’s Department of Surgery is at the forefront of this movement, integrating AI to revolutionise patient care.
Dr Yuman Fong, chair of Surgery at City of Hope, highlights AI's transformative impact.
He said: ‘The potential of AI in surgery is extraordinary. We’re already seeing significant improvements in hospital efficiency and patient care.’
Machine learning, a critical subset of AI, uses large datasets to uncover patterns beyond human recognition.
City of Hope is applying this technology to electronic health records (EHRs) to refine treatment planning.
AI algorithms are proving invaluable in refining risk assessment for surgery. In 2021, City of Hope integrated an algorithm to evaluate the risk of complications following emergency surgery, spearheaded by Dr Lily Lai, a professor of surgery.
She said: ‘Our patient population has unique clinical profiles, so we developed a tailored risk score.’
The algorithm analyses data from EHRs, including changes over time, to offer surgeons a more precise risk prediction tool.
Surgeons using this AI tool have seen a notable reduction in complications, prompting further investigation into its effectiveness.
Dr Lai added: ‘In clinical practice, this risk score helps surgeons make critical decisions. The algorithm highlights key factors influencing surgical outcomes, helping us optimise preoperative care, like adjusting blood counts before surgery. It also helps us ask essential questions, like “What’s the goal of this surgery?” and “How can we best prepare this patient?”’
AI also improves outcomes for patients undergoing complex procedures, such as cytoreductive surgery combined with hyper-thermic intraperitoneal chemotherapy (HIPEC).
Dr Mustafa Raoof, a specialist in abdominal tumours, leads a project analysing over 2,000 patients from the HIPEC Collaborative to develop personalised risk scores for this high-stakes surgery.
The algorithm uncovers nuanced relationships between surgery duration and blood loss factors.
Dr Raoof said: ‘Contrary to traditional thinking, longer surgeries aren’t always riskier – it’s high blood loss that correlates with complications.’
His team is refining individualised risk scores, and pending successful validation, the AI tool could further reduce complications in this patient population.
Beyond the operating room, AI is also shaping postoperative care. In collaboration with Dr Virginia Sun, Dr Fong and his team are developing an AI-based system to tailor postoperative monitoring and recovery plans.
The project, supported by a $4 million grant, aims to use data from wearable sensors and patient-reported outcomes to optimise discharge timing and follow-up care.
Dr Fong said: ‘We want to ensure every patient’s recovery plan is as personalised as possible. AI can help us make nuanced decisions about who can go home earlier, who needs closer follow-up, and how best to support their recovery.’
Dr Fong is optimistic about the future.
‘Eventually, AI will be a standard tool for monitoring all patients at home, helping us catch issues early and intervene before complications arise.’
