Artificial intelligence is now a key tool in medicine, significantly impacting patient care. Experts at the European Association of Urology (EAU) Congress 2026 explored AI's role in urological surgery, detailing successes and challenges.
Augmented Reality in Robotic Surgery
AI is integrating into robotic surgery in three waves: descriptive, generative, and agentic. Agentic AI acts as a co-pilot, activating guidelines, imaging, and patient information during surgery. Augmented reality, through AI, centers the surgeon and benefits the entire team and external observers.
Telesurgery Advances in 2026
Telesurgery, or remote surgery, is becoming more reliable. A 2026 study showed telesurgery to be non-inferior to local surgery for robotic operations, with stable outcomes over distances of 1,000-2,800 km. Guidelines for safe telesurgery adoption are emerging, with the EAU releasing its policy in 2025 and an international consensus conference held in 2024.
Expanding Surgical Expertise via Telementoring
Telemedicine, including telemonitoring and telepreceptoring, is vital given the vast patient need for safe and affordable surgical care, particularly in low and middle-income countries.
Open vs. Closed Console Debate
Robotic surgery consoles are debated. Open consoles, like Medtronic Hugo™ and CMR Surgical Versius®, offer better ergonomics and team communication, reducing surgeon discomfort. Closed consoles, such as Da Vinci®, provide high immersion and focus crucial for complex procedures. Surgeon preference plays a key role.
AI in Urological Surgery: Diagnostics
AI shows superiority over traditional methods in diagnosis and outcome prediction for urological diseases. In renal cancer, AI differentiates benign from malignant tumors. For prostate cancer, AI systems like 'AutoProstate' and those from the PANDA Challenge demonstrate strong performance in analyzing MRI scans and prostate biopsies.
European Experience with AI
Progress in clinical AI integration has been slow, highlighting the need for diverse datasets and validation. Foundation models for generalist medical AI, like SurgVISTA, are emerging for comprehensive surgical scene understanding.
The Future of Robotic Surgery Training
Training is shifting from volume-based to criterion-referenced performance targets. Proficiency-based training has shown significantly higher success rates in reaching benchmarks compared to traditional methods. Continuous monitoring and re-certification are crucial for maintaining surgical consistency.
The future of urological surgery is evolving rapidly with AI and robotics, promising advancements while addressing global disparities and refining surgical education.