npj Digital Medicine (Jul 2022)
A Delphi consensus statement for digital surgery
- Kyle Lam,
- Michael D. Abràmoff,
- José M. Balibrea,
- Steven M. Bishop,
- Richard R. Brady,
- Rachael A. Callcut,
- Manish Chand,
- Justin W. Collins,
- Markus K. Diener,
- Matthias Eisenmann,
- Kelly Fermont,
- Manoel Galvao Neto,
- Gregory D. Hager,
- Robert J. Hinchliffe,
- Alan Horgan,
- Pierre Jannin,
- Alexander Langerman,
- Kartik Logishetty,
- Amit Mahadik,
- Lena Maier-Hein,
- Esteban Martín Antona,
- Pietro Mascagni,
- Ryan K. Mathew,
- Beat P. Müller-Stich,
- Thomas Neumuth,
- Felix Nickel,
- Adrian Park,
- Gianluca Pellino,
- Frank Rudzicz,
- Sam Shah,
- Mark Slack,
- Myles J. Smith,
- Naeem Soomro,
- Stefanie Speidel,
- Danail Stoyanov,
- Henry S. Tilney,
- Martin Wagner,
- Ara Darzi,
- James M. Kinross,
- Sanjay Purkayastha
Affiliations
- Kyle Lam
- Department of Surgery and Cancer, Imperial College
- Michael D. Abràmoff
- Department of Ophthalmology and Visual Sciences, University of Iowa
- José M. Balibrea
- Department of Gastrointestinal Surgery, Hospital Clínic de Barcelona
- Steven M. Bishop
- CMR Surgical Limited
- Richard R. Brady
- Newcastle Centre for Bowel Disease Research Hub, Newcastle University
- Rachael A. Callcut
- Department of Surgery, University of California
- Manish Chand
- Department of Surgery and Interventional Sciences, University College London
- Justin W. Collins
- CMR Surgical Limited
- Markus K. Diener
- Department of General and Visceral Surgery, University of Freiburg
- Matthias Eisenmann
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ)
- Kelly Fermont
- Solicitor of the Senior Courts of England and Wales, Independent Researcher
- Manoel Galvao Neto
- Endovitta Institute
- Gregory D. Hager
- The Malone Center for Engineering in Healthcare, The Johns Hopkins University
- Robert J. Hinchliffe
- Department of Vascular Surgery, University of Bristol
- Alan Horgan
- Department of Colorectal Surgery, Newcastle Hospitals
- Pierre Jannin
- LTSI, Inserm UMR 1099, University of Rennes 1
- Alexander Langerman
- Otolaryngology, Head & Neck Surgery and Radiology & Radiological Sciences, Vanderbilt University Medical Center
- Kartik Logishetty
- Department of Surgery and Cancer, Imperial College
- Amit Mahadik
- Stryker Corporation
- Lena Maier-Hein
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ)
- Esteban Martín Antona
- Department of Surgery, Hospital Clínico San Carlos
- Pietro Mascagni
- Fondazione Policlinico Universitario A. Gemelli IRCCS
- Ryan K. Mathew
- School of Medicine, University of Leeds
- Beat P. Müller-Stich
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital
- Thomas Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), Universität Leipzig
- Felix Nickel
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital
- Adrian Park
- Department of Surgery, Anne Arundel Medical Center, School of Medicine, Johns Hopkins University
- Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”
- Frank Rudzicz
- Department of Computer Science, University of Toronto
- Sam Shah
- Faculty of Future Health, College of Medicine and Dentistry, Ulster University
- Mark Slack
- CMR Surgical Limited
- Myles J. Smith
- The Royal Marsden Hospital
- Naeem Soomro
- Department of Urology, Newcastle Upon Tyne Hospitals NHS Foundation Trust
- Stefanie Speidel
- Division of Translational Surgical Oncology, National Center for Tumor Diseases (NCT/UCC)
- Danail Stoyanov
- Wellcome/ESPRC Centre for Interventional and Surgical Sciences, University College London
- Henry S. Tilney
- Department of Surgery and Cancer, Imperial College
- Martin Wagner
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital
- Ara Darzi
- Department of Surgery and Cancer, Imperial College
- James M. Kinross
- Department of Surgery and Cancer, Imperial College
- Sanjay Purkayastha
- Department of Surgery and Cancer, Imperial College
- DOI
- https://doi.org/10.1038/s41746-022-00641-6
- Journal volume & issue
-
Vol. 5,
no. 1
pp. 1 – 9
Abstract
Abstract The use of digital technology is increasing rapidly across surgical specialities, yet there is no consensus for the term ‘digital surgery’. This is critical as digital health technologies present technical, governance, and legal challenges which are unique to the surgeon and surgical patient. We aim to define the term digital surgery and the ethical issues surrounding its clinical application, and to identify barriers and research goals for future practice. 38 international experts, across the fields of surgery, AI, industry, law, ethics and policy, participated in a four-round Delphi exercise. Issues were generated by an expert panel and public panel through a scoping questionnaire around key themes identified from the literature and voted upon in two subsequent questionnaire rounds. Consensus was defined if >70% of the panel deemed the statement important and <30% unimportant. A final online meeting was held to discuss consensus statements. The definition of digital surgery as the use of technology for the enhancement of preoperative planning, surgical performance, therapeutic support, or training, to improve outcomes and reduce harm achieved 100% consensus agreement. We highlight key ethical issues concerning data, privacy, confidentiality and public trust, consent, law, litigation and liability, and commercial partnerships within digital surgery and identify barriers and research goals for future practice. Developers and users of digital surgery must not only have an awareness of the ethical issues surrounding digital applications in healthcare, but also the ethical considerations unique to digital surgery. Future research into these issues must involve all digital surgery stakeholders including patients.
