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Journal Articles npj Digital Medicine Year : 2022

A Delphi consensus statement for digital surgery

Kyle Lam
Michael Abràmoff
José Balibrea
  • Function : Author
Steven Bishop
  • Function : Author
Richard Brady
  • Function : Author
Rachael Callcut
  • Function : Author
Manish Chand
  • Function : Author
Markus Diener
  • Function : Author
Kelly Fermont
Manoel Galvao Neto
Gregory Hager
Robert Hinchliffe
  • Function : Author
Alan Horgan
  • Function : Author
Alexander Langerman
Kartik Logishetty
Amit Mahadik
  • Function : Author
Esteban Martín Antona
  • Function : Author
Ryan Mathew
Thomas Neumuth
Felix Nickel
  • Function : Author
Gianluca Pellino
Frank Rudzicz
  • Function : Author
Sam Shah
Mark Slack
  • Function : Author
Myles Smith
  • Function : Author
Naeem Soomro
  • Function : Author
Stefanie Speidel
  • Function : Author
Danail Stoyanov
  • Function : Author
Henry Tilney
  • Function : Author
Martin Wagner
Ara Darzi
James Kinross
  • Function : Correspondent author
  • PersonId : 1164171

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Sanjay Purkayastha


The use of digital technology is increasing rapidly across surgical specialities, yet there is no consensus for the term ‘digital surgery’. This is critical as digital health technologies present technical, governance, and legal challenges which are unique to the surgeon and surgical patient. We aim to define the term digital surgery and the ethical issues surrounding its clinical application, and to identify barriers and research goals for future practice. 38 international experts, across the fields of surgery, AI, industry, law, ethics and policy, participated in a four-round Delphi exercise. Issues were generated by an expert panel and public panel through a scoping questionnaire around key themes identified from the literature and voted upon in two subsequent questionnaire rounds. Consensus was defined if >70% of the panel deemed the statement important and <30% unimportant. A final online meeting was held to discuss consensus statements. The definition of digital surgery as the use of technology for the enhancement of preoperative planning, surgical performance, therapeutic support, or training, to improve outcomes and reduce harm achieved 100% consensus agreement. We highlight key ethical issues concerning data, privacy, confidentiality and public trust, consent, law, litigation and liability, and commercial partnerships within digital surgery and identify barriers and research goals for future practice. Developers and users of digital surgery must not only have an awareness of the ethical issues surrounding digital applications in healthcare, but also the ethical considerations unique to digital surgery. Future research into these issues must involve all digital surgery stakeholders including patients.
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Dates and versions

hal-03776203 , version 1 (20-01-2023)


Attribution - CC BY 4.0



Kyle Lam, Michael Abràmoff, José Balibrea, Steven Bishop, Richard Brady, et al.. A Delphi consensus statement for digital surgery. npj Digital Medicine, 2022, 5 (1), pp.100. ⟨10.1038/s41746-022-00641-6⟩. ⟨hal-03776203⟩
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