American Association of Plastic Surgeons

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Artificial Intelligence in Plastic and Reconstructive Surgery: A Systematic Review
Joseph M. Firriolo, MD, Laura C. Nuzzi, BA, John G. Meara, MD, DMD, MBA, Brian I. Labow, MD.
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

PURPOSE:
Artificial intelligence (AI) refers to the use of computing to model intelligent behavior with minimal human involvement; it is a rapidly expanding, multidisciplinary field with many surgical applications. AI encompasses machine learning (ML) and surgical robotics (SR). The purpose of this study is to determine the current and future applications of AI in plastic and reconstructive surgery and to infer the role of surgeons in the development and implementation of such technologies.
METHODS:
We performed a comprehensive literature review on articles published on AI, ML, and SR. Articles were selected for their relevance to plastic and reconstructive surgery and reviewed for their discussion of the applications and practical/ethical limitations of AI in practice.
RESULTS:
A total of 468 English language articles were identified from a PubMed query. Nineteen articles met the inclusion criteria, describing applications of AI pertaining to aesthetic surgery, wound care, burns management, microsurgery, craniofacial surgery, patient safety, and resident teaching/evaluation. The applications of ML were largely related to generating algorithms for patient assessment/diagnosis, surgical planning, and outcomes measurement. Surgical robots are to become increasingly capable of assisting surgeons, both manually and cognitively. Of note, three articles rose ethical and safety concerns regarding surgical AI should surgeons fail to establish appropriate safeguards.
CONCLUSION:
AI has the potential to enhance the evidence-base and quality of surgical care. It is important that plastic surgeons - as innovators, leaders, and patient advocates - are closely involved in the implementation of surgical AI and the resolution of ethical and safety considerations.


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