Artificial interfaces ("AI") in surgery: Historic development, current status and program implementation in the public health sector

The past two decades have seen considerable advances in the application of artificial interfaces (AI) in surgery. Several have been developed including AESOP (Automated Endoscopic System for Optimal Positioning), Zeus and the Da Vinci Surgical System (DVSS). Whilst each has advantages DVSS is being used increasingly across multiple surgical specialities. These developments generate many challenges in an era where the emphasis is increasingly on safer and cost-effective surgery. Whilst the role of DVSS is firmly established in urologic and gynaecologic surgery, the role of DVSS in gastrointestinal surgery is evolving. Recent data indicate that it is at least as oncologically effective, whilst providing numerous benefits (e.g. reduced conversion and complication rates) over traditional laparoscopic approaches. The increasing adoption of AI/DVSS worldwide places institutes and health sectors under increasing pressure to adopt and develop such programs. This article provides (1) an update on the current status of AI in surgery in general and in colorectal surgery and (2) an appraisal of the cost implications of the establishment and implementation of AI/DVSS-based provisions in the public health sector. The numerous challenges faced generate many opportunities in the implementation of present and future surgical technologies.