Artificial intelligence in gastrointestinal surgery: A systematic review

Table 6 Artificial intelligence based and robotics enhanced surgical education and performance assessment

Ref.	Surgical procedure/task	AI method/model	Assessment modality	Data type/source	Performance metrics	Educational outcome
Garfinkle et al[53], 2022	Gastrointestinal and endoscopic surgery (priority setting)		Survey/Delphi	Survey data from SAGES member surgeons		Identified core needs: Video training, tech adoption
Huo et al[54], 2024	Surgical decision making for GERD	ChatGPT 3.5/4, copilot, Google Bard, Perplexity AI	Prompt based guideline comparison	Standardized clinical vignettes based on SAGES guidelines	Surgeons (accuracy): Bard 6/7 (85.7%), ChatGPT 4 5/7 (71.4%); patients (accuracy): Bard 4/5 (80.0%), ChatGPT 4 3/5 (60.0%); children: Copilot & Bard 3/3 (100.0%)	Revealed inconsistencies in LLM advice; need for medical domain training
Huo et al[55], 2024	Surgical management of GERD	Generic ChatGPT 4 vs customized GPT (GTS)	Prompt based guideline comparison	60 surgeon cases and 40 patient cases based on SAGES and UEG EAES guidelines	GTS (custom GPT): 100% accuracy for both surgeons (60/60) and patients (40/40), generic GPT 4 66.7% (40/60) for surgeons, 47.5% (19/40) for patients	Demonstrated impact of domain customization in LLMs
Nasir et al[56], 2021	Robotic rectal cancer surgery	No AI model used (robotics only)		RCTs, observational studies, registry data	Reduced conversion to open surgery (especially in obese/male patients); improved urogenital function; no difference in long term oncologic outcomes	Reinforced need for structured robotic training (e.g., EARCS)

AI: Artificial intelligence; SAGES: Society of American Gastrointestinal and Endoscopic Surgeons; GERD: Gastroesophageal reflux disease; LLM: Large language model; GTS: Gastroesophageal reflux disease tool for surgery; UEG: United European Gastroenterology; EAES: European Association for Endoscopic Surgery; RCTs: Randomized controlled trials; EARCS: European Academy of Robotic Colorectal Surgery.