Plenary VII - Artificial Intelligence and Robotics in Endoscopy and Surgery

Urology is the first surgical specialty to adopt widespread use of robotic surgery, and robotic radical prostatectomy is one of the most commonly performed robotic surgery worldwide. Besides prostatectomy, robotic surgery is also commonly performed in nephrectomies, cystectomies, pyeloplasties and other urinary reconstructive surgeries. While the robotic surgery market has been a monopoly in the past 20 years, numerous new multi-port robotic systems in the form of boom or module types have emerged in recent years to provide alternatives for patients and surgeons. Next generation single port and endoscopic robotic systems have enabled new indications and operative techniques. Artificial intelligence (AI) in Urological diseases has been developed in various imaging modalities like Ultrasound and MRI prostate, and also in endoscopic modalities like automated bladder cancer detection and renal stone localization during surgery. It is expected that the combination of robotics and AI will be the future of Urological management. 

Artificial intelligence (AI) has demonstrated a huge potential to transform the real-world practice of gastrointestinal endoscopy: i) improved quality metrics and reduced lesion miss rate in AI-assisted colonoscopy, ii) guided anatomical structure recognition and lesion segmentation in hepatobiliary endoscopy, iii) reduced reading time and enhanced lesion detection in capsule endoscopy, iv) critical structure identification in advanced therapeutic endoscopy. It will enhance training efficiency, standardize outcomes, and ultimately improve patient care.
From intra-procedural guidance to post-procedural feedback, AI can address the current challenges that we are facing in education. However, the major concerns before a universal implementation include risks of deskilling, over-reliance and ethical considerations. Governing frameworks must address data privacy and transparency, algorithmic bias and interpretability, and legal accountability.
In the future, the next generation endoscopy training requires a stepwise approach to integrate AI into traditional mentorship, aiming to balance technical and humanistic competencies.