What is Surgery 4.0?
Seance of wednesday 19 february 2025 (Nouvelle nomenclature, nouveaux paradigmes)
DOI number : 10.26299/ym53-fy15/2025.07.05
Abstract
Surgery 4.0 derives its name from an analogy with the term "Industry 4.0", introduced by Klaus SCHWAB, President and Founder of the World Economic Forum (WEF) in Davos in 1976, to signify the advent of the Fourth Industrial Revolution (IR4). This transition marks the shift of our society from the information era to a globally interconnected world. The acceleration of this transformation is driven by the ability to process vast amounts of data using adaptive artificial intelligence techniques (AI/ML/DL/LLM) combined with robotics. This progress has been made possible by advances in graphical processing units (GPUs), increased computing and storage power of modern computers, high-speed fiber-optic networks, cloud computing, and the Internet of Things (IoT), allowing for real-time global data exchange, processing, and actions.
Surgery 4.0 applies these technologies to surgical practices, forming a subset of the broader transition into the era of Personalized Precision Medicine (5P). These advancements have given rise to a specialized field known as "Surgical Data Science", theorized in the early 2000s, particularly in France by our fellow academician Jocelyne TROCCAZ The current global rapporteur of this research group is Klaus Maier-Hein from Heidelberg. Additionally, Mirgen JAKU, one of the key figures behind Johnson & Johnson’s Ottava robotics project, popularized the classification of surgical evolution into four stages, culminating in Surgery 4.0.
During my presentation, I will discuss the digital loop integration in surgical practices, emphasizing the importance of structuring the surgical community around data collection, management, and processing. A key focus will be the essential role of federated learning in enabling real-time clinical research (practice evaluation, innovation assessment, and medical device lifecycle under MDR regulations).
Furthermore, I will explore the prerequisites and potential designs for an adequate infrastructure, including concepts such as Building Operating System (BOS), specialized data centers, and a centralized command center (Smart Surgical Board). Finally, I will conclude with two reflections aimed at regulators, payers, and policymakers, proposing strategies to accelerate and enhance the deployment of surgical innovations without introducing new disparities in healthcare access.
Surgery 4.0 applies these technologies to surgical practices, forming a subset of the broader transition into the era of Personalized Precision Medicine (5P). These advancements have given rise to a specialized field known as "Surgical Data Science", theorized in the early 2000s, particularly in France by our fellow academician Jocelyne TROCCAZ The current global rapporteur of this research group is Klaus Maier-Hein from Heidelberg. Additionally, Mirgen JAKU, one of the key figures behind Johnson & Johnson’s Ottava robotics project, popularized the classification of surgical evolution into four stages, culminating in Surgery 4.0.
During my presentation, I will discuss the digital loop integration in surgical practices, emphasizing the importance of structuring the surgical community around data collection, management, and processing. A key focus will be the essential role of federated learning in enabling real-time clinical research (practice evaluation, innovation assessment, and medical device lifecycle under MDR regulations).
Furthermore, I will explore the prerequisites and potential designs for an adequate infrastructure, including concepts such as Building Operating System (BOS), specialized data centers, and a centralized command center (Smart Surgical Board). Finally, I will conclude with two reflections aimed at regulators, payers, and policymakers, proposing strategies to accelerate and enhance the deployment of surgical innovations without introducing new disparities in healthcare access.