AI-Enhanced Surgical Practice: From Pre-Operative Modeling to Real-Time Decision Support

Abstract

Artificial intelligence–guided surgery has emerged as one of the most transformative developments in contemporary operative practice, offering new capabilities for precision, personalization, and data-driven decision-making across the surgical continuum. This review synthesizes international evidence on the integration of AI into pre-operative planning, intraoperative navigation, and emerging digital ecosystems, highlighting the contributions of diverse regions including Mexico, Colombia, and Ecuador. The analysis demonstrates that pre-operative applications are the most mature, supported by robust advances in deep learning, computer vision, and predictive modeling that enable high-resolution anatomical reconstruction, improved risk stratification, and more consistent surgical pathway selection. Intraoperative systems, although less prevalent, represent an accelerating frontier. Real-time AI tools are increasingly capable of identifying anatomical structures, recognizing procedural phases, and guiding instrument trajectories, thus enhancing safety and reducing operator variability in complex procedures. Despite these advances, substantial gaps persist in validation maturity; most systems rely on retrospective datasets, with relatively few having undergone multicenter prospective testing or real-time operative deployment. Emerging technologies such as digital twins and extended reality show considerable promise for personalized simulation and dynamic intraoperative adaptation, yet they remain in early stages of clinical translation. Geographic analysis reveals pronounced imbalances in global contributions but also highlights the growing engagement of Latin American institutions in surgical AI research. Overall, the findings indicate that AI-guided surgery is transitioning from experimental innovation to a clinically relevant complement to surgical expertise. Continued interdisciplinary collaboration, rigorous validation, and equitable global participation will be fundamental to advancing safe, effective, and widely accessible AI-enhanced operative care.

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