Artificial intelligence (AI) is rapidly reshaping gastrointestinal (GI) surgery by enhancing decision-making, intraoperative performance, and postoperative management. The integration of AI-driven systems is enabling more precise, data-informed, and personalized surgical interventions. This review provides a state-of-the-art overview of AI applications in GI surgery, organized into four key domains: surgical simulation, surgical computer vision, surgical data science, and surgical robot autonomy. A comprehensive narrative review of the literature was conducted, identifying relevant studies of technological developments in this field. In the domain of surgical simulation, AI enables virtual surgical planning and patient-specific digital twins for training and preoperative strategy. Surgical computer vision leverages AI to improve intraoperative scene understanding, anatomical segmentation, and workflow recognition. Surgical data science translates multimodal surgical data into predictive analytics and real-time decision support, enhancing safety and efficiency. Finally, surgical robot autonomy explores the progressive integration of AI for intelligent assistance and autonomous functions to augment human performance in minimally invasive and robotic procedures. Surgical AI has demonstrated significant potential across different domains, fostering precision, reproducibility, and personalization in GI surgery. Nevertheless, challenges remain in data quality, model generalizability, ethical governance, and clinical validation. Continued interdisciplinary collaboration will be crucial to translating AI from promising prototypes to routine, safe, and equitable surgical practice.

Purpose: Automating suturing in robotic-assisted surgery offers significant benefits including enhanced precision, reduced operative time, and alleviated surgeon fatigue. Achieving this requires robust computer vision (CV) models. Still, their development is hindered by the scarcity of task-specific datasets and the complexity of acquiring and annotating real surgical data. This work addresses these challenges using a sim-to-real approach to create synthetic datasets and a data-driven methodology for model training and evaluation. Methods: Existing 3D models of Da Vinci tools were modified and new models–needle and tissue cuts–were created to account for diverse data scenarios, enabling the generation of three synthetic datasets with increasing realism using Unity and the Perception package. These datasets were then employed to train several YOLOv8-m models for object detection to evaluate the generalizability of synthetic-trained models in real scenarios and the impact of dataset realism on model performance. Additionally, a real-time instance segmentation model was developed through a hybrid training strategy combining synthetic and a minimal set of real images. Results: Synthetic-trained models showed improved performance on real test sets as training dataset realism increased, but realism levels remained insufficient for complete generalization. Instead, the hybrid approach significantly increased performance in real scenarios. Indeed, the hybrid instance segmentation model exhibited real-time capabilities and robust accuracy, achieving the best Dice coefficient (0.92) with minimal dependence on real training data (30–50 images). Conclusions: This study demonstrates the potential of sim-to-real synthetic datasets to advance robotic suturing automation through a simple and reproducible framework. By sharing 3D models, Unity environments and annotated datasets, this work provides resources for creating additional images, expanding datasets, and enabling fine-tuning or semi-supervised learning. By facilitating further exploration, this work lays a foundation for advancing suturing automation and addressing task-specific dataset scarcity.

Purpose: Cardiovascular diseases are the leading cause of mortality globally. Advances in interventional radiology and endovascular devices have made endovascular procedures effective alternatives to traditional open surgery, leading to their routine application in clinical practice. Within this framework, novel technologies, including robotic platforms and navigation software, have been developed to assist clinicians in executing endovascular interventions with improved dexterity, enhanced guidance, and superior clinical training, ultimately yielding better patient outcomes. Methods: This study aims to develop a model-based simulation environment within the SOFA framework, to enable shape and force sensing for endovascular robotic procedures. The vascular catheter was modeled using beam theory, and realistic interactions between the catheter and vascular models were established using the finite element method (FEM) with both linear elastic and nonlinear hyper-elastic models. Experiments measured contact forces and positional changes during catheter insertion, comparing anatomical deformations with simulation results. Results: Experimental tests validated the simulated force and displacement measurements. The catheter contact force showed an absolute error of 0.0371 N (30.45%). Catheter tip displacement averaged 3.1 mm, and the proximal segment’s Fréchet distance averaged 3.6 mm. For the anatomical model, the elastic FEM model performed best, with deformation measurement errors of 34%, 19%, and 59% across three different force scenarios. Conclusion: The results indicate that the integration of advanced physical modeling, realistic human–robot interactions, and enhanced computational capabilities will facilitate the development of innovative solutions, enabling clinicians to achieve greater accuracy and reliability in minimally invasive surgical (MIS) applications, particularly in endovascular interventions.

Purpose Cardiovascular diseases are the leading cause of mortality globally. Advances in interventional radiology and endovascular devices have made endovascular procedures effective alternatives to traditional open surgery, leading to their routine application in clinical practice. Within this framework, novel technologies, including robotic platforms and navigation software, have been developed to assist clinicians in executing endovascular interventions with improved dexterity, enhanced guidance, and superior clinical training, ultimately yielding better patient outcomes. Methods This study aims to develop a model-based simulation environment within the SOFA Framework, to enable shape and force sensing for endovascular robotic procedures. The vascular catheter was modeled using beam theory and realistic interactions between the catheter and vascular models were established using the Finite Element Method (FEM) with both linear elastic and nonlinear hyper-elastic models. Experiments measured contact forces and positional changes during catheter insertion, comparing anatomical deformations with simulation results. Results Experimental tests validated the simulated force and displacement measurements. The catheter contact force showed an absolute error of 0.0371 N (30.45%). Catheter tip displacement averaged 3.1 mm, and the proximal segment’s Fréchet distance averaged 3.6 mm. For the anatomical model, the Elastic FEM model performed best, with deformation measurement errors of 34%, 19%, and 59% across three different force scenarios. Conclusion The results indicate that the integration of advanced physical modeling, realistic human-robot interactions, and enhanced computational capabilities will facilitate the development of innovative solutions, enabling clinicians to achieve greater accuracy and reliability in minimally invasive surgical (MIS) applications, particularly in endovascular interventions.