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BackgroundTechniques utilizing artificial intelligence (AI) are rapidly growing in medical research and development, especially in the operating room. However, the application of AI in the operating room has been limited to small tasks or software, such as clinical decision systems. It still largely depends on human resources and technology involving the surgeons’ hands. Therefore, we conceptualized AI-based solo surgery (AISS) defined as laparoscopic surgery conducted by only one surgeon with support from an AI-based surgical assistant system, and we performed an electronic survey on the clinical desire for such a system. ObjectiveThis study aimed to evaluate the experiences of surgeons who have performed laparoscopic surgery, the limitations of conventional laparoscopic surgical systems, and the desire for an AI-based surgical assistant system for AISS. MethodsWe performed an online survey for gynecologists, urologists, and general surgeons from June to August 2017. The questionnaire consisted of six items about experience, two about limitations, and five about the clinical desire for an AI-based surgical assistant system for AISS. ResultsA total of 508 surgeons who have performed laparoscopic surgery responded to the survey. Most of the surgeons needed two or more assistants during laparoscopic surgery, and the rate was higher among gynecologists (251/278, 90.3%) than among general surgeons (123/173, 71.1%) and urologists (35/57, 61.4%). The majority of responders answered that the skillfulness of surgical assistants was “very important” or “important.” The most uncomfortable aspect of laparoscopic surgery was unskilled movement of the camera (431/508, 84.8%) and instruments (303/508, 59.6%). About 40% (199/508, 39.1%) of responders answered that the AI-based surgical assistant system could substitute 41%-60% of the current workforce, and 83.3% (423/508) showed willingness to buy the system. Furthermore, the most reasonable price was US $30,000-50,000. ConclusionsSurgeons who perform laparoscopic surgery may feel discomfort with the conventional laparoscopic surgical system in terms of assistant skillfulness, and they may think that the skillfulness of surgical assistants is essential. They desire to alleviate present inconveniences with the conventional laparoscopic surgical system and to perform a safe and comfortable operation by using an AI-based surgical assistant system for AISS.

Simple Summary: Prior research has identified various prognostic markers in epithelial ovarian cancer (EOC), including BRCA mutation status and a response to platinum-based chemotherapy, to predict outcomes in patients undergoing PARP inhibitor maintenance therapy. The role of CA-125 elimination rate constant K (KELIM), although recognized as a prognostic indicator, has not been fully investigated. This study underscores the prognostic significance of KELIM, revealing that a favorable KELIM score significantly correlates with better PFS in patients treated with primary cytoreductive surgery (PCS) followed by PARP inhibitor therapy. It also shows that KELIM's predictive value varies with the timing of surgery, extending a different view of its utility in real-world practice. KELIM could be integrated into clinical decision-making processes, potentially informing future clinical guidelines and research into optimal treatment strategies for targeted use of PARP inhibitors in advanced EOC patients. Background: This multicenter retrospective study aimed to investigate the prognostic value of the CA-125 elimination rate constant K (KELIM) in EOC patients who received platinum-based chemotherapy followed by PARP inhibitors, in either upfront or interval treatment settings. Methods: Between July 2019 and November 2022, we identified stage III–IV EOC patients who underwent primary or interval cytoreductive surgery and received olaparib or niraparib. Individual KELIM values were assessed based on validated kinetics and classified into favorable and unfavorable cohorts. Results: In a study of 252 patients undergoing frontline maintenance therapy with olaparib or niraparib, favorable KELIM (≥1) scores were associated with a higher PFS benefit in the primary cytoreductive surgery (PCS) cohort (hazard ratio (HR) for disease progression or death 3.51, 95% confidence interval (CI); 1.37–8.97, p = 0.009). Additionally, within the interval cytoreductive surgery (ICS) cohort, a favorable KELIM score (≥1) significantly increased the likelihood of achieving complete resection following cytoreductive surgery, with 59.4% in the favorable KELIM group compared to 37.8% in those with unfavorable KELIM. Conclusions: A favorable KELIM score was associated with improved PFS in patients with advanced EOC undergoing PCS. Furthermore, in the ICS cohort, a favorable KELIM score increased the probability of complete cytoreduction. [ABSTRACT FROM AUTHOR]