Surgical interventions, particularly in neurology, represent complex and high-stakes scenarios that impose substantial cognitive burdens on surgical teams. Although deliberate education and practice can enhance cognitive capabilities, surgical training opportunities remain limited due to patient safety concerns. To address these cognitive challenges in surgical training and operation, we propose SurgBox, an agent-driven sandbox framework to systematically enhance the cognitive capabilities of surgeons in immersive surgical simulations. Specifically, our SurgBox leverages large language models (LLMs) with tailored Retrieval-Augmented Generation (RAG) to authentically replicate various surgical roles, enabling realistic training environments for deliberate practice. In particular, we devise Surgery Copilot, an AI-driven assistant to actively coordinate the surgical information stream and support clinical decision-making, thereby diminishing the cognitive workload of surgical teams during surgery. By incorporating a novel Long-Short Memory mechanism, our Surgery Copilot can effectively balance immediate procedural assistance with comprehensive surgical knowledge. Extensive experiments using real neurosurgical procedure records validate our SurgBox framework in both enhancing surgical cognitive capabilities and supporting clinical decision-making. By providing an integrated solution for training and operational support to address cognitive challenges, our SurgBox framework advances surgical education and practice, potentially transforming surgical outcomes and healthcare quality. The code is available at https://github.com/franciszchen/SurgBox.

Objective: A median of 14.4% of patient undergone at least one adverse event during surgery and a third of them are preventable. The occurrence of adverse events forces surgeons to implement corrective strategies and, thus, deviate from the standard surgical process. Therefore, it is clear that the automatic identification of adverse events is a major challenge for patient safety. In this paper, we have proposed a method enabling us to identify such deviations. We have focused on identifying surgeons' deviations from standard surgical processes due to surgical events rather than anatomic specificities. This is particularly challenging, given the high variability in typical surgical procedure workflows. Methods: We have introduced a new approach designed to automatically detect and distinguish surgical process deviations based on multi-dimensional non-linear temporal scaling with a hidden semi-Markov model using manual annotation of surgical processes. The approach was then evaluated using cross-validation. Results: The best results have over 90% accuracy. Recall and precision were superior at 70%. We have provided a detailed analysis of the incorrectly-detected observations. Conclusion: Multi-dimensional non-linear temporal scaling with a hidden semi-Markov model provides promising results for detecting deviations. Our error analysis of the incorrectly-detected observations offers different leads in order to further improve our method. Significance: Our method demonstrated the feasibility of automatically detecting surgical deviations that could be implemented for both skill analysis and developing situation awareness-based computer-assisted surgical systems.

Despite the advancements in Robotics and Artificial Intelligence, Robots have not learnt how to show emotion… just yet…but when we think of robots, more often than not images of clunky humanoid contraptions, metal with hinged joints and bulky movement spring to mind (excuse the pun). Whilst there are lots of applications for hard robotic machines such as factory lines, farming, military purposes, robots are evolving into more pliable and adaptable artificial organisms. As the use of robotics increases, as does the need for more malleable machines that can assist in more intricate tasks. Building on this need, we've found ourselves entering into a new and exciting realm of engineering, the next generation of robots – soft robotics. The field of soft robotics is still in its infancy and there's still a lot of new ground to cover.