Journal Article Review Ahead of print
PubMed: 41654983 DOI: 10.1186/s13017-026-00674-2
Artificial intelligence in emergency surgery: a scoping review within the artificial intelligence in emergency and trauma surgery (ARIES) project.
World J Emerg Surg
Authors: Belinda De Simone, Lucienne Kasongo, Andrew A Gumbs, Fabrizio Vecchio, Alberto De Franceschi, Nicola DèAngelis, Andrew W Kirkpatrick, Juan P Wachs, Tyler J Loftus, Fikri M Abu-Zidan, Rifat Latifi, Genevieve Deeken, Elie Chouillard, Andrey Litvin, Massimo Sartelli, Desiree Pantalone, Ari Leppäniemi, Mehmet Eryilmaz, Kemal Rasa, Arda Isik, Haytham M Kaafarani, Gustavo Fraga, Raul Coimbra, Ernest E Moore, Walter L Biffl, Fausto Catena
Affiliations
- Department of Emergency and General Minimally Invasive Surgery, Bufalini Hospital, AUSL Romagna, Via Ghirotti 286, 47521, Cesena, Italy.
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate (CO), Italy.
- General Hospital of Kinshasa, Avenue de L'hopital, Kinshasa, Democratic Republic of Congo.
- Department of Minimally Invasive Viscerale and Digestive Surgery, Hôpital Antoine Béclère, AP-HP, Université Paris-Saclay, Clamart, France.
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele, Rome, Italy.
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate (CO), Italy.
- Department of Law, University of Ferrara, Ferrara, Italy.
- Department of Surgery, Fondazione Poliambulanza Instituto Ospedaliero, Brescia, Italy.
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
- Foothills Medical Centre, Alberta Health Services, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada.
- Department of Critical Care Medicine, University of Calgary, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada.
- Gerald D. and Edna E. Mann Hall, Regenstrief Center for Healthcare Engineering, Suite 225, 203 S. Martin Jischke Drive, West Lafayette, IN, 47907-1971, USA.
- School of Industrial Engineering, Purdue University, 610 Purdue Mall, West Lafayette, IN, 47907, USA.
- Department of Surgery, University of Florida Health, Gainesville, FL, USA.
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
- The University of Arizona, Tucson, AZ, USA.
- Tucson Medical Center, Tucson, AZ, USA.
- Centre de Recherche en Epidemiologie Et Statistiques (CRESS), Sorbonne Paris Cité University, 75006, Paris, France.
- Epidemiology of Childhood and Adolescent Cancers (EPICEA), Hôpital Paul Brosse AP-HP, 94800, Villejuif, France.
- Department of General and Bariatric Surgery, American Hospital of Paris, 92200, Neuilly-Sur-Seine, France.
- Department of Surgical Diseases No. 3, Gomel State Medical University, University Clinic, Gomel, Belarus.
- Department of General Surgery, Macerata Hospital, Macerata, Italy.
- Department of Experimental and Clinical Medicine, University of Florence, 50134, Florence, Italy.
- Emergency Surgery Unit-Trauma Team, Trauma Center, Careggi University Hospital, 50134, Florence, Italy.
- Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
- Department of Surgery, Gülhane Medical Faculty, Gülhane Education & Training Hospital, 06010, Ankara, Turkey.
- Department of Surgery, Anadolu Medical Center, Kocaali, Turkey.
- Istanbul Medeniyet University, Istanbul, Turkey.
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
- Division of Trauma, Emergency Surgery, Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil.
- Riverside University Health System Medical Center, Riverside, CA, USA.
- Ernest E Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA.
- Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, San Diego, CA, USA.
- Department of Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126, Bologna, Italy.
- Department of General Surgery, Level I Trauma Center, Bufalini Hospital, AUSL Romagna, 47522, Cesena, Italy.
Abstract
AIM
To map and critically appraise the current literature on Artificial Intelligence (AI) applications in emergency general surgery, with a focus on clinical decision-support tools for preoperative risk stratification and intraoperative assistance, and to identify ethical, structural, and regulatory barriers to implementation.
METHODS
A scoping review was conducted within the ARIES project, following established methodological frameworks. Relevant studies evaluating AI-based tools in emergency surgical settings were systematically identified and analyzed.
RESULTS
The literature describes AI applications mainly in two domains: preoperative decision support, including risk prediction and diagnostic or triage models for acute abdominal and traumatic conditions, and intraoperative assistance, largely focused on computer vision-based systems for anatomical recognition, safety guidance, and navigation in minimally invasive emergency procedures. Additional contributions address training and telementoring platforms, as well as cross-cutting ethical, legal, and regulatory considerations relevant to AI adoption in emergency surgical care.
CONCLUSIONS
AI has the potential to complement emergency surgeons' clinical judgment, but its routine adoption in emergency surgical practice remains limited. Addressing methodological, ethical, and regulatory challenges, together with the development of robust data infrastructures and targeted training pathways, is essential to support safe, effective, and equitable implementation in acute care settings. In addition, the lack of dedicated investment and sustainable funding models for large-scale clinical implementation and prospective evaluation represents a critical barrier to the translation of AI from research into routine emergency surgical practice.
MeSH
Intelligence, Emergencies, Artificial Intelligence, Wounds And Injuries, Acute Care Surgery