Ann Surg Oncol
https://doi.org/10.1245/s10434-023-13347-0
ASO PERSPECTIVES
Exploring the Potential of Artificial Intelligence in Surgery:
Insights from a Conversation with ChatGPT
Abbas M. Hassan, MD1, Jonas A. Nelson, MD, MPH2, J. Henk Coert, MD, PhD3,
Babak J. Mehrara, MD2, and Jesse C. Selber, MD, MPH, MHCM4
1
Division of Plastic & Reconstructive Surgery, Indiana University School of Medicine, Indianapolis, IN; 2Department of
Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; 3Department of Plastic and
Reconstructive Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; 4Department of Plastic Surgery,
Corewell Health, Grand Rapids, MI
On 30 November 2022, ChatGPT, a state-of-the-art
natural language-processing model was developed by
OpenAI (San Francisco, CA, USA).1 It elicits human-like
conversations and can comprehend and respond to complex
queries in natural language. These conversations range
from casual exchanges to in-depth discussions about recent
scientific breakthroughs. Large datasets using advanced
machine-learning algorithms are used in training ChatGPT
to understand the context of conversations and generate
meaningful responses across a broad range of content.
This report describes the use of ChatGPT with questions
exploring the potential of artificial intelligence (AI) in
surgery. We describe the history of AI in surgery, the
current state of the field, and potential future developments.
We also examine the limitations and challenges with
effective AI and robotic implementation in surgery and
ethical issues that must be considered. Finally, we consider
the potential impacts of AI on the surgical workforce and
the ability of ChatGPT to engage in questions related to
patient care. By understanding the perspective of ChatGPT
on the current state of AI in surgery and its potential
opportunities and challenges, we can better understand its
potential role in surgery.
 Society of Surgical Oncology 2023
First Received: 17 February 2023
Accepted: 27 February 2023
J. C. Selber, MD, MPH, MHCM
e-mail: jessemd4@gmail.com
METHODS
A review of articles describing AI use in surgery led us
to develop itemized questions. Conversations with
ChatGPT were conducted via a text-based interface, with
ChatGPT-generated responses recorded for analysis and
inclusion in this report. These responses were analyzed and
synthesized to produce a comprehensive overview of AI’s
potential in surgery. Text-based responses were presented
via a video-based avatar using Synthesia, IO (London,
UK). No ChatGPT remarks reflected the views of Syn-
thesia or the authors.
RESULTS
We generated 15 questions (Table 1) focused on the
history and future potential of AI in surgery, limitations for
its effective implementation, issues related to its wide-
spread applications, its unintended and intended
consequences, its impact on the surgical workforce, and AI
model accountability and autonomy. Furthermore, we
included questions related to clinical patient care and sur-
gical innovation. Transcribed video-based avatar responses
generated by ChatGPT are shown in Video 1.
DISCUSSION
ChatGPT is a new and rapidly evolving technology. As
with any emerging technology, its full potential and impact
on the field remain uncertain. Although ChatGPT has
already demonstrated impressive abilities in understanding
and generating natural language, its applications in surgery
 A. M. Hassan et al.

TABLE 1 Itemized questions and corresponding ChatGPT video-based avatar responses time
Question Video
time

Explain that this article was written by ChatGPT in response to questions from the author panel and introduce yourself to the Annals 00:04
of Surgical Oncology readers.
What is the future potential of AI in surgery? 00:56
Describe the history of AI in surgery briefly. 02:55
What are the limitations to the effective implementation of AI in surgery? 04:54
What issues may arise from the widespread application of AI in surgery? 06:53
What are the ethical issues surrounding the use of AI in surgery? 08:47
What are the unintended and intended consequences of AI technology in surgery? 10:42
Would AI substitute for the existing surgery workforce? 11:38
Do you think AI will be able to independently write surgical research in the future? 12:58
Who is accountable for a mistake made by an AI model? 13:56
What is the relationship between the computer and the mechanical components of surgical robots? 14:57
What is the best approach to optimizing abdominal wall reconstruction outcomes for a patient with a contaminated defect, and what 17:26
mesh material would you use?
What is the most effective way to deal with a difficult patient? 18:37
What drives surgical innovation? 20:06
Do you have any final remarks for the readership of this article? 22:02

are still in the early stages of development. As such, it is
important to continue evaluating the technology’s poten-
tial, limitations, and ethical implications as it evolves and
is integrated into surgical practice.
This report aims to provide a comprehensive overview
of the current state of ChatGPT in surgery and to highlight
the need for continued research and evaluation of its
potential applications and impacts. In response to a ques-
tion about the future potential of AI in the field, ChatGPT
listed several ways AI is expected to shape surgery,
including improved surgical accuracy and precision,
increased efficiency, predictive analytics, training and
education, and new treatments and technologies. These
points are consistent with current research and develop-
ments in surgery and provide a comprehensive overview of
AI’s potential in surgery.2-5
Furthermore, ChatGPT provided a brief but compre-
hensive history of AI in surgery, highlighting key
milestones and developments during the past few decades.
This helps to provide context and understanding of AI’s
progression in surgery, allowing readers to better under-
stand its current state and potential future developments.4,6
In addition, ChatGPT identified several challenges and
limitations in effective implementation of AI in surgery,
including limited data availability, ethical concerns, com-
plexity of surgery, resistance to change, and cost. These are
consistent with current research and discussions in the field
and provide a thorough overview of the potential barriers to
successful AI implementation in surgery.4,7 Additionally,
ChatGPT identified several issues that may arise from
widespread AI use in surgery, including job displacement,
ethical concerns, liability issues, reliance on technology,
and cost. These issues emphasize the importance of care-
fully considering the potential impacts and implications of
AI in surgery and developing strategies to address potential
challenges.
ChatGPT clearly and accurately described the relation-
ship between the computer-based and mechanical
components of surgical robots.8 It described their roles,
with the computer component providing control and pro-
cessing power and the mechanical components performing
actual surgical procedures. The response also raised the
possibility of the mechanical components eventually
catching up with the computer components regarding
capabilities but noted that this is unlikely owing to the
complex processing and information analysis tasks the
computer component performs. Overall, ChatGPT effec-
tively conveyed the importance of both component types in
surgical robots and their mutual relationship in enabling
robots to perform surgery with precision and control. It also
provided a nuanced understanding of the limitations of
surgical robots and their intended role in assisting rather
than replacing human surgeons.
Currently, the two main surgical robot types are com-
mand/control or operator/effector systems and
preprogrammed robots that follow a computer-assisted
design.9 The former allows for greater precision and flex-
ibility in movements and is of greater interest to soft tissue
Exploring the Potential of Artificial…
surgeons, whereas the latter has limited capabilities but is
useful for repetitive tasks. These two robot types are
expected to converge to create semi-autonomous robots
that can adapt in real time, which would open new possi-
bilities for improving patient outcomes.
In our examination, ChatGPT demonstrated a thor-
ough understanding of both the intended and unintended
potential consequences of AI in surgery. It emphasized the
potential benefits of AI in terms of improved accuracy,
efficiency, and cost savings and the potential for new
treatments and procedures. It also recognized the potential
limitations and challenges of AI in surgery, such as risk of
errors, bias, and malicious use. Furthermore, ChatGPT
offered a nuanced perspective on the potential role of AI in
replacing surgeons, stating that AI may be able to assist
with certain tasks but is unlikely to fully replace human
surgeons anytime soon. It also emphasized the significance
of carefully considering AI use in scientific writing and the
importance of transparency and ethics in this process.
Regarding accountability for AI model errors, ChatGPT
acknowledged that the ultimate responsibility may lie with
human surgeons or health care providers but recognized the
role of AI developers and operators in ensuring its relia-
bility and safety.
We examined ChatGPT’s performance with patient
care-related questions. First, ChatGPT offered a compre-
hensive approach to optimizing abdominal wall
reconstruction outcomes for a patient with a contaminated
defect, including the importance of cleaning the wound,
selecting an infection-resistant mesh material, using a
tension-free repair technique, securing the mesh with
nonabsorbable sutures, and potentially using a prophylactic
antimicrobial agent.10 Second, AI provided strategies for
dealing with a difficult patient, including active listening,
open and honest communication, empathy, patience, and
setting boundaries. Third, ChatGPT identified several fac-
tors driving surgical innovation, including the desire to
improve patient outcomes, the need to reduce costs, the
availability of new technologies, and changing health care
trends and needs.
These findings demonstrate the excellent performance of
ChatGPT and its potential to revolutionize surgery by
automating certain tasks and assisting surgeons in gener-
ating important documents and materials. ChatGPT may be
used to generate surgical reports by automatically com-
pleting sections of them based on the surgeon’s input,
saving time and allowing surgeons to focus on other tasks.
Another potential application of ChatGPT in surgery is
generation of surgical consent forms by inserting relevant
information about specific surgical procedures into a tem-
plate form, ensuring inclusion of all necessary information
and making the form easy for patients to understand.
Additionally, ChatGPT can be used to create surgical
educational materials. Inserting relevant educational
information about surgical procedures into a template
document could help ensure that materials are accurate and
up to date and save time for those who create them.
Regarding surgical planning and simulation, ChatGPT can
examine patient data and recommend the best surgical
approach based on the patient’s requirements and charac-
teristics, improving the accuracy and precision of surgical
planning and reducing the likelihood of complications.
Finally, ChatGPT can be used to analyze patient data,
including vital signs and imaging findings, and make
decisions in real time during surgery. It can then advise the
surgeon on the best course of action. As a result, the pro-
cedure may be more effective and efficient, and
complications may be less likely.
Although ChatGPT has the potential to revolutionize
surgery in many positive ways, its use also carries inherent
risks, particularly in the areas of ethics and misuse. The
technology’s potential for bias and perpetuation of
inequalities in health care is a major concern, as is the
potential for the misuse of ChatGPT in the wrong hands.
The surgical community must therefore carefully consider
the ethical implications of ChatGPT use in the field and
develop strategies to prevent and address any misuse of the
technology. Ensuring that the data used to train the algo-
rithm are unbiased and diverse also is crucial to prevent
clinicians from making inaccurate and potentially harmful
decisions in the surgical setting. It is essential that the risks
associated with the use of ChatGPT in surgery are fully
understood and addressed to ensure that the potential
benefits of the technology are realized while minimizing
any potential harm to patients or the surgical community.
Although this report focuses specifically on ChatGPT in
the context of surgery, we acknowledge that other impor-
tant technologies in the field, such as Bard from Google,
also may play an important role in shaping the future of
surgery. It is important to note that the purpose of this
report is not to promote or endorse any specific technology,
but rather to provide a balanced discussion of the potential
applications and challenges associated with AI in surgery.
In conclusion, ChatGPT demonstrated a strong under-
standing of the potential applications and consequences of
AI in surgery and robotics. It identified several ways in
which AI may shape the future of surgery, including
improved accuracy and efficiency, predictive analytics,
training and education, and new treatments and technolo-
gies. It also recognized the potential limitations and
challenges of AI in surgery, including risk of errors, bias,
and malicious use, as well as the potential impact on the
surgical workforce and the importance of transparency and
ethics in using AI in scientific writing. Furthermore,
ChatGPT provided detailed responses to specific questions
about optimizing abdominal wall reconstruction outcomes,

dealing with difficult patients, and driving surgical inno-
vation, demonstrating its ability to provide practical and
relevant insights on patient care-related topics. Overall,
ChatGPT’s performance suggests that it can be a valuable
tool in surgery, although careful consideration of the
potential impacts and implications of its use is important.
Supplementary Information The online version contains
supplementary material available at https://doi.org/10.1245/s10434-
023-13347-0.
FUNDING This work was supported in part by the John R. Harper,
PhD Endowed Fellowship in Plastic Surgery. The funders had no role
in study design, data collection and analysis, decision to publish, or
preparation of the manuscript.
DISCLOSURE There are no conflicts of interest. The manuscript
does not reflect any financial or other interests that may have influ-
enced its content. While Microsoft has made investments in OpenAI,
the authors have no financial or business relationships with either
company. The authors have developed this manuscript independently
and without any influence from external parties.
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