Innovation, disruptive technologies and transformation in vascular surgery

The digital transformation has reached the discipline of vascular surgery and although the basic principles of physician-patient relationship remain untouched, technical innovations such as robotics, surgical navigation, artificial intelligence, augmented/virtual reality (AR/VR) and 3D printing require our attention. It is essential that these digital technologies are critically evaluated and followed up with respect to their potential application and implementation. Despite the beneficial results of robotic systems in other surgical disciplines, they are currently not frequently used in vascular surgery. In contrast, intraoperative navigation is widely implemented and facilitates the execution of complex endovascular procedures. Due to the broad diversification, the topic of artificial intelligence can only be cursorily mentioned but is considered highly relevant with respect to its influence in the context of image recognition, data analysis and procedural surveillance. The current fields of application for AR/VR devices encompass simulation and training with the potential advantages of saving time and reduction of errors. The AR technology has already been tested for use in surgery (but is not yet mature enough for the practice), whereas for VR the question of the principal possibility for use in surgery must still be clarified. In addition to the use for clarification, training and simulation purposes 3D printing technology also enables the production of individualized high-fidelity 3D surgical templates. The technologies presented here for the digital transformation of surgery (surgery 4.0) represent very promising innovations and their implementation enables the next important step in the direction of patient-specific precision medicine.