By Andrew Savarese, global head of digital surgery at PA Consulting
Ten years ago, when asked “what do you need”, surgeons would have said a sharper scalpel – but today they are asking for a smarter one. Just last month, we saw the world’s youngest patient operated on by a robot. At Guy’s and St Thomas’ NHS Foundation Trust in London, nearly all kidney, prostate, and lung cancer surgery are now undertaken with robotic assistance.
And at the University of California in San Diego, surgeons are performing operations while wearing Apple’s mixed-reality headsets. The digitisation of surgery has begun.
Developments like these have arisen not only from a technology readiness, but also a psychological willingness to embrace new devices that help save, extend, or improve patient lives. The change has not been an overnight phenomenon – but it has certainly become more deeply embedded in the past few years.
This has been spurred on by visionary companies in surgical robotics, navigation, and AI pushing the boulder uphill, releasing their data-forward platforms, like Intuitive’s DaVinci 5, and completing strategic acquisitions, such as Stryker with Care.ai. So what’s next for digital surgery?
Data will take centre stage
One notable change is that data is no longer a word shrouded in mystery in healthcare. In fact, we are now hearing everyone from large multinationals to start-ups clamouring for as much data as they can get their hands on. The issue, however, isn’t data’s lack of abundance but rather the access to it. Research shows that around 97 per cenr of data in the healthcare setting still goes untouched, representing a huge opportunity lost in the pursuit of improving care, especially as companies sit looking for this information.
So why do we need it? Robotics, sensors, and navigation systems in operations use and produce vast quantities of data. When shared between surgical teams, this data can enhance patient outcomes by enabling a more accurate, seamless, and tailored surgical experience. But to really transform surgical care, the biggest challenge to address in 2025 is data access.
This calls for the entire ecosystem of stakeholders – including patients, surgeons, hospitals, and health systems – to embrace safe and secure data-sharing. Consent and data ownership issues, particularly when hospitals could profit from patient data, are a major barrier to adopting smart surgical technology over traditional methods. Many patients hesitate to consent to sharing their data, which highlights why strong cybersecurity measures and steps to anonymise and protect their information are so important.
Robotics and digital surgery devices therefore also need to be designed and architected to share their “ones and zeros” so the platforms seeking this information can read it holistically. This will allow us to determine why a movement was made, how tissue is responding, and gather information as to what should – and more importantly should not – be done next in the procedure to produce the best outcome.
The challenge is that if surgical platforms cannot access that data, algorithms are just empty code. If the data is poor, we are left with potentially confusing or harmful hallucinations or false insights. And ultimately, if we are not careful with the quality of digital surgery software packages, we risk setting the entire discipline back not just years, but decades.
Enabling industry-wide AI adoption
As we look to solve the data-sharing conundrum, we must also have a way of processing this informational resource as the data is being generated. This means pushing the boundaries of compute and data transmission to glean insights from these algorithms instantaneously.
The massive volume of data generated in surgery simply cannot be processed quickly enough by humans to inform or guide surgeons intra-operatively. And if we disregard the user needs component of how we display the data and when we show it, we serve to increase the cognitive burden on practitioners rather than lessen it.
Balanced, human-centred design, whereby surgeons can easily pull real-time insights using AI, can unlock the potential for the right insights at the right time, driving the adoption and development of future technologies in the same breath.
As part of this, I would love to see our industry embrace the speed of innovation and AI developments happening in the consumer technology space. This would involve maturing the internal processes to develop with speed, without losing the much-needed rigor that ultimately protects the patient and the practitioner.
Raising healthcare standards globally
Surgical technologies are evolving faster now than potentially ever before. By summer 2024 alone, over 100 AI-enabled digital surgery platforms had been approved, and it stands to reason that we will see this number continue to increase rapidly.
Frankly, I would not be surprised if over 200 platforms gain FDA approval status by late 2025. With those platforms comes a whole new paradigm of treatment pathways and the opportunity for healthcare to become proactive versus reactive.
And while the widespread adoption of advanced digital surgery may still be another decade away, that is not stopping the industry from continuing to push the boundaries of innovation.
These advancements don’t seek to replace surgical teams, but rather digital systems can act as powerful tools that enhance their capabilities, resulting in more efficient, precise procedures, which could translate into quicker recoveries and reduced hospital stays – ultimately transforming health outcomes for millions of people worldwide.
