Rzeszów/ Pioneering surgeries at the university hospital supported by artificial intelligence

Doctors at the University Hospital in Rzeszów performed the first surgeries in Poland using a surgical robot and 3D technology supported by artificial intelligence (AI). While removing a kidney tumor, they gained X-ray-like insight into what lies beneath the tissue surface.

The innovative procedures were performed at the Fryderyk Chopin University Clinical Hospital in Rzeszów at the end of June. These were partial nephrectomy procedures, the removal of a kidney tumor, performed with the help of the da Vinci robot. Behind the console sat Dr. Jakub Kempisty, a urologist, certified surgeon, and robotic surgery trainer.

Doctors previously performed a detailed diagnosis of the patients. Using computed tomography, they took a series of images, which were converted into a 3D image. During the surgery, a 3D model of the kidney was superimposed on the image of the patient's organs, allowing Dr. Kempisty to continuously monitor his chosen surgical strategy.

"The artificial intelligence algorithm, combined with the 3D image, analyzed what we were doing during the surgery and followed us, showing us in real time where the tumor and vessels were located. The kidney is hidden under layers of fat and fascia, so it's not immediately visible upon entering the abdominal cavity. The 3D model indicated its exact location and the location of key blood vessels. It was a map that could tell us which direction to move to find what we were looking for," Dr. Kempisty explained in an interview with PAP.

The 3D visualization system, based on artificial intelligence algorithms, was developed in Belgium by Marco Mezzina, an engineer at Orsi Academy and a PhD candidate at the Catholic University of Leuven. Orsi is one of the largest and most prestigious training centers for robotic surgery in the world.

Augmented reality in surgery allows for the creation of a patient-specific 3D map of vessels, tumors, and other landmarks directly onto the endoscopic scene, giving the surgeon a "transparent" view of structures beneath the surface, explained Marco Mezzina, who oversaw the system's clinical trials during the surgery.

"In oncology procedures such as partial nephrectomy, this allows for guidance of the resection plane, shortening ischemia time, and helping to preserve healthy tissue. However, clinical adoption has lagged, primarily because virtual models are difficult to align with soft tissue that shifts during surgery, and because the overlay can obscure instruments the surgeon needs to see," he added.

The kidney tumor removal surgeries were observed by engineers from the Rzeszów University of Technology, who are now considering how to improve the system.

"We can collaborate on expanding the AI ​​model with a speech recognition module, something like Chata GPT. During surgery, the doctor has his hands full, but can issue voice commands. He could also control the 3D model, position it, temporarily zoom out, or receive a warning when approaching blood vessels. All this to make using additional tools simple and intuitive," said Dr. Stefan Stagraczyński, assistant professor at the Department of Physics and Medical Engineering at the Rzeszów University of Technology.

This is just one scenario for the collaboration between engineers from the Polish Medical University and Belgium. The university hospital is already planning further surgeries using the latest IT software systems.

– Such operations are not only a major technological step, but also practical proof that our center can be a place for testing and implementing solutions that change treatment standards – added Marcin Rusiniak, director of the University Clinical Hospital.

Agnieszka Lipska (PAP)

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