Title : Artificial intelligence in colorectal surgery: From preoperative planning to intraoperative navigation
Abstract:
Artificial intelligence is increasingly influencing colorectal surgery by supporting more accurate diagnosis, individualized operative planning, real-time decision-making, and postoperative risk prediction. This keynote address will examine how AI is being integrated across the surgical pathway, with particular emphasis on its transition from preoperative assessment to intraoperative navigation. Preoperatively, AI-assisted imaging can facilitate tumor detection, staging, anatomical segmentation, assessment of vascular structures, and prediction of lymph-node involvement. Machine-learning models may also support patient selection, anticipate technical difficulty, and estimate the likelihood of conversion, anastomotic leakage, postoperative complications, and oncological outcomes. By combining radiological, pathological, clinical, and genomic data, these systems may enable more personalized treatment strategies and improve multidisciplinary decision-making. Intraoperatively, computer vision and advanced image-analysis technologies are creating new opportunities for surgical navigation. Potential applications include recognition of operative phases, identification of critical anatomical landmarks, delineation of dissection planes, assessment of tissue perfusion using fluorescence imaging, and real-time alerts during laparoscopic and robotic procedures. Integration with augmented reality, robotic platforms, and digitally connected operating rooms may further enhance precision, standardization, training, and patient safety. However, the adoption of AI in colorectal surgery also presents important challenges. Algorithmic bias, variable data quality, limited external validation, lack of interpretability, cybersecurity concerns, regulatory uncertainty, and medico-legal accountability must be addressed before widespread clinical implementation. Surgeons must remain central to the design, evaluation, and governance of these technologies. AI should not be viewed as a replacement for surgical expertise, but as a tool that augments clinical judgment and technical performance. This keynote will highlight current innovations, practical limitations, and future directions, emphasizing the need for robust evidence, ethical oversight, multidisciplinary collaboration, and surgeon-led implementation.
