Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video

BACKGROUND: The creation of operative reports is a tedious documentation task that increases administrative burden, which is a potential driver of burnout. Additionally, operative reports are inherently subjective and may contain inaccuracies and incomplete information. Recent advances in artificial intelligence (AI) technology have enabled computer vision systems to accurately detect operative steps on surgical video. We aim to develop a platform for the automated creation of video-based AI surgical operative reports in robotic-assisted radical prostatectomy. STUDY DESIGN: An AI computer vision algorithm was used to automatically detect surgical steps. Each step detected on video was mapped to prespecified text, which was then compiled into a narrative AI operative report. The accuracy of the AI operative reports was compared with operative reports written by surgeons, using expert review of raw surgical video footage as the ground truth. RESULTS: A total of 158 cases from a tertiary referral center were included. In surgeon operative reports, 84 cases (53.2%) had at least 1 discrepancy between the operative report and surgical video. Of these, 43 cases (27.2%) had a clinically significant discrepancy based on expert video review. In AI operative reports, 46 cases (29.1%) had at least 1 discrepancy between the operative report and surgical video. Of these, 20 cases (12.7%) had a clinically significant discrepancy. Overall accuracy was higher for AI operative reports compared with surgeon operative reports (87.3% vs 72.8%, p = 0.001). CONCLUSIONS: Operative reports created by AI achieved higher accuracy than those written by surgeons. To our knowledge, this is the first report of automated video-based AI surgical documentation. Future studies are warranted to explore the potential for this novel tool to reduce documentation burden, improve operative report accuracy, promote surgical transparency, and decrease subjectivity in surgical documentation.