Two hundred participants answered the survey. Of these, 134 (67%) work in academic centers, 58 (20%) in community hospitals, and six (3%) in private clinics. One hundred twenty-nine (64%) were consultants, 42 (21%) were attending surgeons, and 29 (14%) were residents. Sixty-two (31%) surgeons have a work experience of 11-20 years, 55 (27%) of 5-10 years, 39 (19%) of less than 5 years, 23 (11%) more than 30 years, and 21(10%) of 21-30 years. Only 32 were females (16%). One hundred seventy-two (86%) surgeons were confident that AI will improve their acute care surgery practice, 17 (8.5%) thought that it will not affect their job, while 6 thought that it will make it more difficult (3%).
Seventy-five surgeons (37.5%) perform minimally invasive surgery in 51-75% of their procedures, 44 (22%) in 25-50 % of their procedures, 38 (19%) in 76-90% of their procedures, 24 (12%) in less than 25% of their procedures, 12 (6%) (12/200) in more than 90% of their procedures while seven surgeons (3.5%) do not perform minimally invasive surgery. Minimally invasive surgery was performed in both elective and emergency surgery by 149 surgeons (74.5%), only in elective surgery by 39 (19%) surgeons, and only in emergency surgery by 8 surgeons (4%). Fifty surgeons (25%) were trained on robotic surgery and can perform it. Only 19 (9.5%) were currently performing robotic surgery.
One hundred twenty-six (63%) surgeons do not have a robotic system in their institution, and for those who have it, it was mainly used for elective surgery. One hundred ten surgeons (55%) have experience in the 3D system of vision which was mainly in elective surgery. Only 100 surgeons (50%) were able to define different AI terminologies like general and narrow AI, machine and deep learning, supervised and unsupervised learning, computer vision and natural language processing. Seventy-seven surgeons (38.5%) read AI-based surgical articles and feel comfortable with their details, whereas 56 (28%) didn’t read articles about AI (Table 1, Appendix 2). Seventy-seven (38.5%) surgeons think that AI can extremely improve emergency and trauma surgery, and 99 (49.5%) were highly interested in courses or research projects about the application of AI in emergency surgery (Figure 1: A-B). The majority of the participants thought that they are quick adopters for new technologies Figure 1-C.
The majority of surgeons believe that AI in emergency surgery can be useful to support peri-operative decision making, improved surgical vision, surgical practice, training, and education (Table 1). The highest areas were training and education (61.5%), perioperative decision making (59.5%), and improved surgical vision (53%), (Table 1). 93% of the surgeons thought that high technologies such as the da Vinci System, I-Drive and Ligasure should be included in future research. The majority (93%) of the surgeons want to be involved in future research. Appendix 3 summarises the suggested research topics by the participants.
Seventy-nine surgeons (39.5%) systematically collect clinical data in their practice (videos, images and databases), 61 (30.5%) occasionally collect data (videos of surgical procedures), and 39 (19.5%) collected data by official requests. The majority of surgeons (149, 74.5%) were confident that AI will be available in their setting in the future.
There was no statistically significant difference between males and females in ability, interest in training and expectations of AI (p values 0.91, 0.82, and 0.28 respectively, Mann-Whitney U test).
There was also no statistically significant difference between residents, attending surgeons and consultants in ability, interest in training and expectations of AI (p values 0.82, 0.82, and 0.93 respectively, Kruskal-Wallis test). Ability was significantly correlated with interest and expectations (p< 0.0001 Pearson rank correlation, rho 0.42 and 0.47 respectively) but not with experience (p = 0.9, rho -0.01) (Table 2).