The Field of Super-Minimally Invasive Surgery: A Key Development Direction for Artificial Intelligence and Surgical Robots

Abstract: Super-minimally invasive surgery (SMIS) represents a cutting-edge field driving the innovation and upgrading of contemporary surgery. It establishes diagnostic and therapeutic channels based on a novel surgical approach system, including natural body cavities, natural multi-compartment pathways, tunnel access, and puncture micro-access. By creating natural or artificial minimally invasive operating spaces within the body, these access routes reach target lesions with minimal tissue damage, abandoning the modes of traditional open incision and extensive dissection, and maximally preserving the anatomical integrity and physiological functions of organs.
With the core principles of organ preservation and radical lesion eradication, SMIS has achieved a broad expansion of diagnostic and therapeutic indications. It not only covers the radical treatment of early-stage tumors, but also extends to precise lesion resection of advanced tumors after multidisciplinary team (MDT) evaluation, precise resection of various benign tumors, and corrective treatment of functional diseases. Meanwhile, it enables safe diagnostic and therapeutic operations within the biliary and pancreatic duct system, realizing protective surgery that preserves the function of the papillary sphincter, which greatly improves the safety of minimally invasive treatment for complex hepatobiliary and pancreatic diseases.
Artificial intelligence (AI) and surgical robots serve as the core support for the implementation and popularization of SMIS technology. Preoperatively, AI can perform high-definition imaging screening, precise localization and classification of lesions, and intelligently plan individualized minimally invasive surgical paths. Intraoperatively, relying on the ultra-precise manipulation capability of robots and the AI intelligent recognition system, important structures such as blood vessels and nerves can be accurately identified and avoided, achieving meticulous dissection of lesions and precise sealing and repair of wound surfaces, thus reducing the risks of intraoperative injury and bleeding.
Postoperatively, AI enables full-cycle precise management and early prediction of the occurrence of various complications. The in-depth integration of artificial intelligence and surgical robots breaks through the shortcomings of traditional minimally invasive operations, including limited visual field, tactile deviation, and weak postoperative controllability, and represents the core direction for the future development of super-minimally invasive surgery toward precision, function preservation, and intellectualization.

Enqiang Linghu is a Professor, Chief Physician and Doctoral Supervisor. He currently serves as Director of the Department of Gastroenterology at the First Medical Center of Chinese PLA General Hospital, Director of Beijing Key Laboratory of Digital Diagnosis and Treatment Research and Development for Super-Minimally Invasive Surgery, Chairman of the Gastroenterology Physicians Branch of Chinese Medical Doctor Association, Former Chairman of the Digestive Endoscopy Branch of Chinese Medical Association, and Chairman of the Gastroenterology Expert Committee of the National Health Commission for Capacity Building and Continuing Education. He is the recipient of the Wu Jieping Medical Innovation Award in 2019, and was honored as one of China's Top 10 Medical Experts with Outstanding Contributions in 2023. As the Chief Scientist of the National Key Research and Development Program for both the 13th and 14th Five-Year Plan periods, he has won the ACG International Award from the American College of Gastroenterology three times, along with the Second Prize of the National Science and Technology Progress Award, the First Prize of the Military Science and Technology Progress Award, and the First Prize of the Beijing Science and Technology Progress Award, among other academic honors. He has published English monographs including 《Therapeutics of Digestive Endoscopic Tunnel Technique》 and 《Super Minimally Invasive Surgery: Gastrointestinal Endoscopy Section》.