Making Surgery Less Dangerous: Is Automation Really the Answer?

Any surgery is typically prone to complications, human errors or never events. These continue to occur, causing significant harm to patients and resulting in catastrophic consequences, prolonged hospital stays and increased costs.

According to recent studies, more than a third of patients admitted to hospitals suffer from adverse effects related to their procedure while 1 in 5 experience these complications because of medical errors.

Surgical automation, which integrates advanced software, algorithms, and machinery, aims to improve precision, efficiency, and safety. For instance, preoperative risk assessment systems use AI algorithms to analyze patient data and identify potential complications, enabling more informed surgical planning.

Robotic surgery platforms, such as the da Vinci Surgical System, provide enhanced precision and dexterity, allowing surgeons to perform minimally invasive procedures with reduced risk. Automated processes are designed to make surgeries more economical, effective, and ultimately safer.

There are several ways automation is already being implemented in surgery, from assistive robotics (RAS) like the da Vinci Surgical System to partially or fully automated procedures.

We sat down with Bjoern von Siemens, the founder of Caresyntax to discuss whether automation is really the answer to safer, more predictable surgery.

Q: How would you define surgical automation?

A: Surgical automation happens in various ways, defined by how the surgery is done today. It includes preparatory phases, patient assessments, administrative tasks, post-surgery recovery, and aftercare.

Currently, nurses, surgeons, or administrators perform most of these tasks manually. For example, a patient assessment evaluates factors like background, comorbidities, and environment. With automation, an algorithm can analyze relevant data to assign a risk score — enhancing decision-making through data.

I would say you take a predominantly human-led decision-making process and introduce decision support or automation for clinical and administrative tasks.

Automated systems are already widely used in some areas, such as room disinfection. However, physical interventions in most surgical areas, from cardiac surgery to orthopedics, remain human-led. Technologies like robotic arms assist but are piloted by surgeons rather than fully automated.

In ophthalmology, automation is further along; LASIK surgery is pretty much automated, leading to predictable and safe outcomes.

Q: Talking a bit more about different kinds of surgery, what distinguishes robotic-assisted surgery, or RAS, from computer-assisted surgery, CAS?

A: There's some overlap, and there's some difference.

RAS uses robotic systems (like da Vinci Surgical System), to assist surgeons physically. Robotic systems are usually expensive and used in less than 1% of surgeries worldwide. The da Vinci system is impressive, but CAS is far more scalable and cost-effective.

In contrast, CAS is a data-driven tool for decision support. CAS is used for a wider range of surgeries, from simple procedures to complex operations. Computer-assisted surgery uses data for decision support without requiring robotic arms. It is widely accessible, functioning as anything from a data storage system to advanced tools that assist like an “autopilot.” Its scalability makes it suitable for most surgeries globally.

While RAS remains specific and costly, CAS is rapidly scaling and becoming more accessible to surgeons and patients worldwide

Q: And how do robotic-assisted surgery and computer-assisted surgery technologies improve patient outcomes and reduce risks?

A: Robotic-assisted surgery enhances dexterity, reduces patient risk and minimizes blood loss. RAS also enables traditionally open-chest procedures, such as heart surgery, to be performed minimally invasively, enabling patients to often return home the same day – an outcome impossible with conventional methods.

By inserting a device carefully, these systems dramatically reduce the risk on the patient’s body, making them highly effective in improving patient recovery. This benefits the healthcare system by reducing the high costs associated with these procedures. Additionally, the liability risk in case of potential complications is reduced.

Studies at MK have shown that RAS can reduce complications by up to 20%, minimizing blood loss and shortening recovery times by unto 30%. RAS could also accelerate significantly surgeon’s learning curve to overcome challenges with the lack of experienced surgeons in the coming years.

Computer-assisted surgery provides another support layer, similar to real-time data tracking in other industries. Surgery lacks a fully connected system today, and our goal is to bring this capability to market.

It's not about us but the value it brings to patients. Maximizing the use of surgeons, devices, and operating rooms is crucial given their limited number.

The goal is to improve efficiency, increase throughput, and enhance profitability while ensuring world-class consistency in outcomes. Ultimately, this drives lower total cost of care. It's about treating patients with the highest quality in the most efficient way.

Q: Could you explain how Caresyntax's platforms are contributing to the advancements in robotic-assisted surgery and computer-assisted surgery? What unique value does Caresyntax bring to surgical automation?

A: The platform we've built is unique because, for the first time, it covers the entire surgical journey: before, during, and after surgery.

We provide intraoperative software and data integration for capturing video, device information, and outcomes data. This data isn’t just valuable for immediate use; it’s a resource for improving future surgeries. Unlike most other software, which is procedure- or device-specific.

Caresyntax’s platform is vendor-neutral and scalable across different specialties, unlike others that tend to create siloed data, limiting usability within the broader hospital environment.

The first step is re-establishing this end-to-end surgical platform, which helps both surgeons and hospitals in various ways. It improves efficiency, simplifies workflows, and automates time-consuming tasks like documentation.

Our approach benefits surgeons, medical device companies, and insurers, helping them assess product efficacy and collaborate to enhance patient outcomes. We work as a neutral partner — allowing broad access to data without “locking in” clients or adding unnecessary fees. Making data accessible is crucial to us. Of course, we also need to grow, be profitable, and sell our solutions fairly.

However, as is common with competing systems, we're not trying to lock clients in or charge exorbitant fees for interfaces. We do things differently because we view our relationships with hospitals, surgeons, and the broader ecosystem as long-term partnerships.

This model has driven our success over the past decade and established us as a trusted partner for health systems worldwide.

Caresyntax also uses AI to provide “turn by turn guidance” to OR staff so that they can better support the surgeon by using Real Time Computer Vision AI. Turn by turn guidance recognises the video feed and the different phases of the operation. This feature has multiple benefits including reducing training time for new OR staff, minimizing flow disruptions in the case and reducing case and turn over times with real time progress alerts.

AI is used to provide “lane change assistance” for the surgeons using Real Time Computer Vision AI. Just like how most modern cars have “lane change assistance” to help drivers stay in their lane, Caresyntax AI that helps surgeons to stay in the “lanes” that they had planned to be in and avoid impacting surrounding anatomy which then improves patient safety. Another example is an algorithm that shows when it's safe to fire the Clip Applier. This acts as an extra aid / safety step for the surgeon. Surgery is difficult from a cognitive perspective so the clinical decision-making tool supports and empowers surgeons.

Q: How does Caresyntax's technology improve surgeons' decision-making during operations? Can you provide some real-world examples?

A: Our technology supports decision-making from the initial decision to operate through to post-operative care.

I think the first big decision is whether or not to proceed with the surgery. This decision can be supported by data gathered from the patient — predictive tools help assess whether surgery is the best option, considering factors such as statistical risk of complications based on patient history. We help classify patients as low- or high-risk, which informs decisions about care settings.

Our platform identifies a potential complication preoperatively, allowing the surgical team to take proactive measures to reduce post-surgery complications

If it’s a low-risk patient, you can perform the surgery and discharge them on the same day. If it’s a high-risk one, you need to assess the environment to ensure you can support them in case of an emergency. These are the decisions we help make before surgery.

Our software enhances workflow during surgery by supporting adherence to critical steps, like checklists, which are key to reducing complications. After surgery, we re-evaluate risk factors — this is crucial to avoid follow-up surgeries and support smooth recoveries.

Q: Looking forward, what advancements in surgical automation do you see on the horizon, and how is Caresyntax positioning itself to lead the next wave of innovation?

A: Surgery is a $3 trillion global market — $1 trillion in the U.S., $1 trillion in Europe — with a significant unmet need: 6 billion people lack access to safe surgery. Our innovation focuses on making surgery more accessible, efficient, and safe.

Automation will continue increasing efficiency and throughput while providing better clinical decision support. As automation systems become more autonomous, they will improve results for both patients and healthcare systems. That’s where we’re headed, and that’s the direction we’re supporting.

The integration of AI and automation will evolve, improving both efficiency and patient outcomes. With accessing data platforms like ours will drive the transformation, making surgery safer and more accessible to patients. The future of surgery is not about technology; it’s about using technology to support clinicians.

Our relevance and success stem from having the best-quality primary data. Access to high-quality data is essential for developing the next generation of surgical tools, and Caresyntax is positioned to lead that transformation.