Thursday, May 01, 2025

by Dr. Shakeel Ahmed

This is our second series of articles for this esteemed publication. In our previous series, we explored various healthcare investment opportunities available to healthcare entrepreneurs and physicians. Now, we shift our focus to the future, examining how artificial intelligence (AI) is shaping different aspects of healthcare and healthcare businesses over the next decade and beyond.

“ In the long history of humankind, those who learned to collaborate and improvise most effectively have prevailed.”

– Charles Darwin

AI’s presence in healthcare is well established, so I won’t spend valuable magazine space explaining its fundamentals. Instead, we will dive straight into its impact, starting with AI’s role in surgery. Future articles will explore its influence in fields like preventive medicine, healthcare finance, and Ambulatory Surgery Centers, offering insights into how AI is revolutionizing medicine across multiple domains.

Artificial Intelligence in Surgery: Present and Future:

Artificial Intelligence (AI) is transforming healthcare at a breakneck pace, revolutionizing the way we as clinicians are diagnosing disease processes, performing surgeries, and how we are managing the postop care of our patients.  This is being done at an exponential pace not just in the inpatient setting, but also in the outpatient surgical industry.  In fact, in the latter is where this transformation is most apparent, where artificial intelligence-driven technologies are vastly improving the precision with which surgeries are performed, thereby leading to a reduction in complications and enhancement of results.  As AI continues to integrate into our surgical practices around the US and abroad, it is reshaping our outcomes, minimizing the error which the human mind hitherto would make, and streamlining all of the processes of our care. 

From robotic-assisted surgeries to artificial intelligence-enhanced postoperative and preoperative care, the role for AI is becoming increasingly vital in the evolution of surgery.  As one of the last bastions of the old method of clinical application, physicians like us are watching this change with a mixture of awe, consternation, and positive energy, for the impact in our opinion will continue to expand further beyond current human imagination, leading to safer, more cost effective, and faster procedure times in the same breath.   

AI and Robotic-Assisted Surgery: Enhancing Precision and Efficiency

In my opinion one of the most impressive applications of AI has been in robotic-assisted surgery.  This modality allows for more precision most importantly in minimally invasive procedures, thus leading to better outcomes and much shorter recovery times.  The systems utilized by AI-drive algorithms provide real time guidance in all of the facets of surgical care, improving visualization and assisting the surgeons in executing all of the different complicated maneuvers of surgery with better accuracy. 

The Da Vinci Surgical System by Intuitive Surgical is one of the best and well known AI powered robotic platforms currently being used in our setups.  Since its introduction, it has been deployed in close to 7,000 facilities around the world.  This system is extremely beneficial, and most importantly for minimally invasive surgeries like hernia repairs, microscopic spine surgeries, laparoscopic cholecystectomy, and gynecological procedures.  The robotic arms of the system driving by Artificial Intelligence mimic the movements of the surgeon’s hands, and yet with enhanced stability and dexterity that only a high-end machine can perform.  This leads to a significant reduction in the likelihood of human error.  There is also a 3D high definition visualization system with Da Vinci, which improves the surgeon’s ability to navigate delicate structures, tissues and fields around the human body. 

Medtronic’s Hugo RAS System is also making significant strides in robotic-assisted surgery.  This is a modular AI-enhanced robotic system.  It is designed to bring the benefits hereto mentioned of robotic-assisted surgery to a much broader range of procedures, including urology and gynecology cases.  Just like its competitors, its AI-powered analytics and motion control allow for much better decision making during surgeries than ever before, making it a very valuable asset for outpatient procedures and surgery centers.  Surgery center owners like myself have developed a particular liking for Artificial Intelligence with applications like these, because in spite of all of the other finances and bells and whistles attached with healthcare innovations the most important one is better patient safety and outcome, and AI is showing that to use in real time, pun intended. 

CMR Surgical’s Versius Robot is another Artificial Intelligent powered robotic system which is revolutionizing outpatient surgical care in the fields of colorectal surgery, gynecology, and thoracic surgery.  Unlike its competitors and older models, Versius is designed to be more adaptable and more compact, thus allowing it to be used in more surgically confined places like smaller outpatient surgical centers.  Its AI capabilities help maximize and optimize surgical instruments movement, improve the workflow in the surgical spaces, and thereby lead to enhanced patient safety and comfort. 

In Orthopedic Surgery, Zimmer Biomet’s Rosa (Robotic Surgical Assistant) platform is making news and transforming care in knee and hip replacement surgeries.  This system leverages Artificial Intelligence to accurately analyze a patient’s anatomy, providing real time guidance and feedback to the surgeon during knee and hip joint replacement surgeries.  Rosa’s capabilities help improve patient’s positioning during surgery, reduce the variability needed in these complex and long surgical procedures, and also enhances postsurgical recovery time for patients who are undergoing these cases in an outpatient setting.  I have seen this particularly useful in outpatient joint surgeries in midsized surgery centers where efficacy and time management is key. 

Another significant player in this field is Brainlab’s Cirq, a robotic assistant being used in spine surgery.  Cirq is using AI-driven movement and navigation to assist spine surgeons in placing spinal implants with razor-sharp accuracy, within submillimeter limits.  This is leading to significant improvement in outpatient spine surgery outcomes, where precision in micrometers is crucial for patient outcomes.  Cirq is helping surgeons perform complex spinal surgeries more efficiently by integrating AI-powered automated adjustments and image guidance.  As expected this is leading to faster recovery times and significant reduction in risks of these surgeries.  

AI in Preoperative Planning and Intraoperative Guidance 

Artificial Intelligence as expected is transforming the ways these surgeries are planned even before a patient enters the operating room.  Traditionally preoperative planning relied on images reviewed by the human mind.  Now AI powered platforms can analyze thousands and more of medical images in real time, offering clinicians knowledge and insight that helps the surgeon choose the best approach for every surgery they perform.  Imagine having the clinical acumen and availability of a hundred different doctors at your fingertips guiding you into what the best mode of action should be for your patient’s surgery.  Imagine the results. 

As an example, Surgical Theater’s Precision VR platform utilizes virtual reality and Artificial Intelligence to create a 3D simulation of the surgery.  The surgeon uses this, much like a high level video game the knowledge of which is alien to me at this age, to rehearse complex procedures in a virtual environment before performing them on their actual patients.  Precision VR is extremely used for cardiac procedures and neurosurgical cases, where life and death hinges on millimeters of movement. 

Another cutting edge tool is Asensus Surgical’s Augmented Intelligence Platform, which is helping enhance performance of laparoscopic surgeries but providing Artificial Intelligence-powered intraoperative guidance.  The platform’s AugmentedOR Portal collects and analyzes performed data on surgeries, and helps guide surgeons improve their techniques for the cases and identifies areas and deficiencies in their case.  The overall patient outcome, as expected is better. 

The next frontier for Artificial Intelligence of course was image technology.  There also it is playing a very crucial role in outpatient surgery.  Orthogrid’s AI-based imaging platform is being used to improve the accuracy of joint replacements by optimizing the imaging services performed fluoroscopically during these cases.  In real time this ensures that the implants in patients are placed with the highest level of accuracy needed, which thus leads to better outcomes, success rates and reduction of complications.  

AI in Postoperative Care, Documentation, and Remote Monitoring

Next, but by no means lower on the list, is AI’s role in outpatient surgery in the postop arena.  The documentation of inpatient monitoring process has been improved in a huge way with Artificial Intelligence.  As I can tell you from experience in running multiple surgery centers simultaneously, one of the biggest challenges that surgeons are facing is the time consuming task of postoperative documentation.  AI-powered platforms such as Olive AI and Nuance’s Dragon Medical One automate this process, allowing the surgeons to dictate the note while AI is transcribing and organizing it in real time.  A recent study has found that AI-generated postoperative notes are often more accurate than those written by the surgeons, freeing up valuable time for patient care.  Postoperative surgical monitoring is also being improved by Artificial Intelligence.  Companies like Current Health and Biofourmis are developing wearable technologies that can track a patient’s vital signs even after the surgery is over.  These systems use learning system to detect early signs of complications such as respiratory issues, clotting, infections, etc., and then alert the surgeons and other medical providers before it is too late.  This remote monitoring by Artificial Intelligence is extremely beneficial for outpatient procedures, as I see our patients discharged quicker than ever before and watched even beyond the field of our vision. 

In the field of Pain Management Artificial Intelligence has led to significant reduction and opioid dependency by personalizing the treatment plans for each patient.  Consider this concierge care for patients pay.  Hinge Health, for example is using AI-driven machines and motion sensors that are designed to learn a patients rehab program and customize it for recovery for them.  With the help of these programs patients are regaining mobility and managing their pain in a much more efficient way without having to rely on heavy opioid medications with the resultant complications and long-term dependency.  

The Future of AI in Outpatient Surgery: A Look Ahead  

“ Any sufficiently advanced technology is indistinguishable from magic.”

- Arthur C. Clarke

I can only surmise what will happen next.  Just when we feel that we have a handle on how fast AI can take off, AI takes off at a speed way beyond our guess.  The next decade will witness huge advancement in AI-driven surgical technology.  There are companies, emerging companies, like Proprio which are developing AI-enhanced augmented reality systems that provide real time viewing of human anatomical structures during surgery, reducing the need of a surgeon to rely on typical image screens from current days.  Another system, Avail Medsystems is pioneering tele present surgery, allowing subspecialty and expert surgeons to provide real time guidance remotely, expanding the access to specialized centers beyond their reach which don’t have subspecialty care on premise. 

Predictive analytics are also being developed by AI and being integrated into the ambulatory surgery market to enhance outcomes and improve patient care.  AI can analyze vast amounts of patient date, and predict which patients and individuals are at higher risk for postoperative complications, allowing the surgeons to take measures to prevent those complications even before they operate.  This level of precision will improve surgical safety, ensure better recovery, and most importantly reduce complications. 

AI continues to evolve.  We are poised to only become safer, more efficient and more streamlined.  The integration of Artificial Intelligence with these imaging systems, robotic platforms, and real time navigation tools for surgeons have shown unprecedented and unbelievable results in surgical precision in patient care.  The future is bright.  It is not just about improving one or two surgeries or procedures.  It is about transforming the whole macrocosm of surgery, making higher quality care and results a real option for real people.