[The digital operating room : Chances and risks of artificial intelligence]. / Der digitale Operationssaal : Chancen und Risiken künstlicher Intelligenz.

At the central workplace of the surgeon the digitalization of the operating room has particular consequences for the surgical work. Starting with intraoperative cross-sectional imaging and sonography, through functional imaging, minimally invasive and robot-assisted surgery up to digital surgical and anesthesiological documentation, the vast majority of operating rooms are now at least partially digitalized. The increasing digitalization of the whole process chain enables not only for the collection but also the analysis of big data. Current research focuses on artificial intelligence for the analysis of intraoperative data as the prerequisite for assistance systems that support surgical decision making or warn of risks; however, these technologies raise new ethical questions for the surgical community that affect the core of surgical work.

Eloquent Brain, Ethical Challenges: Functional Brain Mapping in Neurosurgery.

Functional brain mapping is an increasingly relied upon tool in presurgical planning and intraoperative decision making. Mapping allows personalization of structure-function relationships when surgical or other treatment of pathology puts eloquent functioning like language or vision at risk. As an innovative technology, functional brain mapping holds great promise but also raises important ethical questions. In this article, recent work in neuroethics on functional imaging and functional neurosurgery is explored and applied to functional brain mapping. Specific topics discussed in this article are incidental findings, responsible innovation, and informed consent.

Legal and ethical issues in robotic surgery.

AIM: With the rapid introduction of revolutionary technologies in surgical practice, such as computer-enhanced robotic surgery, the complexity in various aspects, including medical, legal and ethical, will increase exponentially. Our aim was to highlight important legal and ethical implications emerged from the application of robotic surgery. METHODS: Search of the pertinent medical and legal literature. RESULTS: Robotic surgery may open new avenues in the near future in surgical practice. However, in robotic surgery, special training and experience along with high quality assessment are required in order to provide normal conscientious care and state-of-the-art treatment. While the legal basis for professional liability remains exactly the same, litigation with the use of robotic surgery may be complex. In case of an undesirable outcome, in addition to physician and hospital, the manufacturer of the robotic system may be sued. In respect to ethical issues in robotic surgery, equipment safety and reliability, provision of adequate information, and maintenance of confidentiality are all of paramount importance. Also, the cost of robotic surgery and the lack of such systems in most of the public hospitals may restrict the majority from the benefits offered by the new technology. CONCLUSION: While surgical robotics will have a significant impact on surgical practice, it presents challenges so much in the realm of law and ethics as of medicine and health care.

Minimally invasive navigated knee surgery: a European perspective.

European surgeons and North American surgeons have different approaches to minimally invasive total knee arthroplasty (TKA). Computer-assisted navigation emphasizes these differences. In this article, the author rethinks what surgeons are trying to achieve and notes that quality control is demanded by patients and surgeons. Although minimally invasive TKA is an accepted procedure, reflection on the facts suggests that the use of minimally invasive surgery and TKA navigation are intertwined and cannot be separated.

Minimally invasive navigated knee surgery: an American perspective.

Minimally invasive total knee replacement surgery may make it possible for patients to undergo the procedure with less pain and recover from the surgery more quickly than has been previously possible. However, minimally invasive techniques have the potential for being associated with a number of complications, including implant and limb malalignment. Computer-assisted technologies used in conjunction with minimally invasive techniques allow the accuracy with which the procedures are performed to be retained.