AI is revolutionising medicine, and one of its most transformative applications is in robotic surgery. On The AI Grapple podcast, I spoke with Dr. Roger Smith, a leading expert in AI-assisted surgical robotics. With a career spanning defence, medical research, and consulting, he’s been at the forefront of this evolution.
We explored how AI is enhancing precision in surgery, making procedures safer, and even paving the way for remote operations. But as with any major technological shift, there are challenges - trust, ethics, and the role of human surgeons in an AI-driven world.
From Military Tech to Medical Breakthroughs
Dr. Smith didn’t start in medicine. His early career focused on software development for military applications. Over a decade ago, he transitioned into healthcare, drawn by the potential of robotic surgery. At the time, the field was still in its early stages - established but not widely understood.
His research focused on training surgeons to use robotic systems effectively. He also studied the way AI could enhance these tools, making surgery more precise and reducing human error. His work revealed a pattern - AI goes through cycles of hype and dismissal. What starts as “magical” eventually becomes normalised. Now, with generative AI at the centre of innovation, we’re in another one of those transformative phases.
How AI Enhances Robotic Surgery
Despite what sci-fi movies might suggest, robotic surgery isn’t about autonomous robots performing operations. Instead, these systems extend a surgeon’s capabilities.
More Precise Movements - The robot translates large hand motions into smaller, controlled actions inside the body, allowing for delicate procedures.
Tremor Reduction - AI eliminates hand tremors, ensuring a steadier, more accurate incision.
Minimally Invasive Procedures - Smaller incisions mean faster recovery times for patients.
AI further enhances these systems by learning from thousands of past surgeries, offering real-time guidance, and even assisting with instrument control.
The Possibility of Remote Surgery
One of the most intriguing possibilities is telesurgery - where a surgeon operates on a patient from miles away. While technically possible, latency issues have made real-world applications limited.
Dr. Smith believes that advancements in satellite internet, like Starlink, could finally make this a reality. A more stable and fast connection would remove lag, allowing a surgeon to operate remotely in real-time. While no one has fully realised this potential yet, the pieces are falling into place.
The Human Factor: Trust and Acceptance
Public perception of robotic surgery has shifted dramatically. A decade ago, many people were sceptical or even fearful. Today, most patients trust the technology. But acceptance depends on the surgeon - some fully embrace robotics, while others stick to traditional methods.
Regulatory bodies like the FDA and Australia’s TGA play a crucial role in ensuring AI-driven surgical tools are safe. But trust isn’t just about regulation – it’s about education. The more people understand how AI assists rather than replaces surgeons, the more they’ll accept it as the new standard.
AI’s Expanding Role in Surgery
AI’s influence is growing across all three phases of surgery:
Before Surgery - AI can analyse a patient’s medical history and compare it with thousands of similar cases, giving doctors more accurate predictions of risks and outcomes.
During Surgery - AI can guide surgeons in real time, assist with movements, and even take control of minor tasks.
After Surgery - AI-powered virtual assistants could provide personalised recovery plans and real-time feedback, ensuring better patient care.
Dr. Smith envisions a future where patients receive their own AI companion post-surgery, offering tailored advice based on their condition and real-time updates to medical teams.
Challenges: Verifying AI’s Reliability
The biggest challenge isn’t technological - it’s trust and verification. AI in surgery must meet a much higher standard than AI in marketing or customer service. A chatbot making an error is one thing, but an AI making a mistake in surgery could be catastrophic.
To be widely adopted, AI-driven surgical tools need to be:
Verifiable - Regulators must confirm AI is reliable and outperforms human-only methods.
Trustworthy - Both doctors and patients need confidence in the system.
Ethically Sound - AI should enhance, not replace, human expertise.
Will AI Replace Surgeons?
It’s a question that comes up in every AI discussion - will AI take over? Dr. Smith believes that while AI will change surgery, it won’t replace human surgeons anytime soon.
Instead, the process will evolve in stages:
AI as an Advisor - Offering real-time guidance based on past procedures.
AI as an Evaluator - Assessing a surgeon’s performance and suggesting improvements.
AI as an Assistant - Controlling instruments for minor surgical tasks.
AI as an Operator - While a fully autonomous AI surgeon isn’t on the horizon yet, it’s a possibility for the distant future.
Bridging Science and Fiction
Beyond his research, Dr. Smith writes medical thriller novels that explore AI’s potential in surgery. His books imagine a world where AI not only assists but drives surgical innovation - developing tools beyond what human hands can create and analysing procedures with unparalleled precision.
Fiction gives him the freedom to push boundaries and ask, What if? His novels explore concepts like multi-fingered robotic instruments, AI-powered surgical overlays, and 360-degree vision systems that capture every detail of an operation. While these ideas may seem futuristic, many are already in early development.
What’s Next? AI-Powered Surgical Training
One of the most exciting near-term developments is AI-driven training for surgeons. Dr. Smith recently worked with a Swedish company to develop a robotic surgery simulator. Unlike traditional training, which relies on human instructors and static programs, this AI-powered system evaluates a surgeon’s technique in real-time.
Future versions could go further, acting as a personal tutor - offering instant feedback, correcting mistakes, and accelerating the learning process. This could revolutionise how surgeons train, making expertise more accessible and reducing the time needed to master complex procedures.
AI is reshaping surgery, but it isn’t about removing human expertise – it’s about enhancing it. The best outcomes will come from AI and surgeons working together, combining human judgment with machine precision.
As AI evolves, the key will be thoughtful integration. The future of robotic surgery isn’t about machines taking over - it’s about making medicine safer, more efficient, and more precise.
If you enjoyed this episode, stay tuned for more insights on The AI Grapple, where we dive into the latest innovations in AI.
Links and Resources:
Modelbenders Consulting: https://www.modelbenders.com
Novels: rddsmith.com