Theatre efficiency
duration. It supports post-operative recovery and helps both anaesthetic and ICU colleagues in terms of planning. He further explained that there are ‘generative’ AI and ‘agentic’ AI components. Generative AI means we have to input data. After performing multiple algorithms and calculations, the technology then provides an answer. Agentic AI is where the technology works virtually autonomously. Dr. Mukherjee urged caution, in terms of AI utilisation, as it is prone to hallucinations and elements of failure. Layers of protection and ethics are vital, therefore. Nevertheless, smart operating theatre rooms are already here: “In North America, AI integrated cameras, sensors and monitoring systems are trying to understand how we are doing what we’re doing, how best to do it more efficiently and where improvements can be made,” he explained. The aim is to improve teamwork and situational awareness, much like the aviation black box, capturing and analysing critical data. However, improvement must build on trust and transparency – not surveillance, he warned. “The metrics or the data that we generate
from this must support systems and not blame individuals. We must not fall into the trap of having a culture where we’re blaming people for certain things – it must embed psychological safety within it. That remains critical,” said Dr. Mukherjee. He also highlighted the importance of having a place where people are free to emote and vent, and this technology needs to allow for this. Culture and regulation will determine the success of AI adoption, he commented: “You need to have an open mind in engaging with it and understanding it – as well as finding faults with it, rectifying it, and re-evaluating it…We are going to be one of the leaders in the world in setting out how we are going to demonstrate AI responsibly and ethically, and we already have a robust network of AI associations…Data privacy and cybersecurity remain paramount. We have to be aware of bias in algorithms and be governed by a sense of regulation and accountability. “As I have emphasised throughout my
presentation, there is a need for human oversight, at every juncture, at every possibility, at the start, middle, and the end, and in between - because we’re the ones that are making these decisions. We’re the ones that are accountable. We are utilising elements of data, but we are the ultimate guardians of what we do for our patients.” With regards to ethical challenges, he added that there needs to be discussions around data ownership, governance, as well as transparency.
Dr. Mukherjee made comparisons with Ignaz Semmelweis – a Hungarian physician known for
20
www.clinicalservicesjournal.com I July 2026
his pioneering work in antiseptic procedures. Semmelweis demonstrated that the incidence of infection could be drastically reduced by requiring healthcare workers in obstetric clinics to disinfect their hands. However, his observations conflicted with the established scientific and medical opinions of the time and his ideas around handwashing were rejected by the medical community. Nevertheless, he stood up for what he believed was right – in the face of significant resistance from colleagues. As Dr. Mukherjee pointed out, Semmelweis was “an agitator within a system that wasn’t functioning well.”
“It can seem like we are over optimising
everything; training must not suffer. As new technologies come in, we must engage with our workforce to ensure they can handle these difficult technological advancements – effectively and well. They must have risks mitigated for them and we need to ensure they avoid burnout through hyper-efficiency. Resilience requires flexibility and engagement, and it must include adaptive capacity built within the teaching and learning environments that we inculcate in our institutions,” he continued. In his final comments, Dr. Mukherjee emphasised that the future theatre ecosystem will utilise AI technology and it will offer dynamic list optimisation, predictive risk modelling, automated documentation and continuous feedback loops. But human leadership and intelligence systems remain critical. We must engage with this process, as the technology is “here to stay”, but we must “make it work to our advantage and for the patient.” “Efficiency is not throughput,” he advised. “It’s access, safety and sustainability…AI and digital systems will enhance what we do, but the culture that we inculcate within our environments drives success,” he commented. In his final comments Dr. Mukherjee advised that AI must recommend, not dictate; it must be explainable, not opaque; it must reduce cognitive load, not add to it; and it must improve safety for everyone – not just productivity metrics. “Ultimately, efficiency always remains a human endeavour,” he concluded.
CSJ
The AfPP exists to advance health by improving patient care in perioperative practice. To find out more about its educational events, visit: https://
www.afpp.org.uk/events/
References 1. Bellini, V., Russo, M., Domenichetti, T. et al. Artificial Intelligence in Operating Room Management. J Med Syst 48, 19 (2024). https://
doi.org/10.1007/s10916-024-02038-2
2. Woodward, C, et al, Risk stratification in hip and knee replacement using artificial intelligence: a dual centre study to support the utility of high- volume low-complexity hubs and ambulatory surgery centres, Intelligence-Based Medicine, (2025),
https://doi.org/10.1016/j. ibmed.2025.100256.
3. Heard, J.R., et al. AI model predicts patient outcomes from surgical gestures and provides insights into explainability. npj Digit. Surg. 1, 4 (2026).
https://doi.org/10.1038/s44484-025- 00006-y
Dr. Mukherjee
Dr. Ankur Mukherjee is a Consultant Urological Surgeon with sub-specialisation in Robotic Pelvic Uro-Oncology at Worcestershire Acute Hospitals NHS Trust. He is also an Associate Lecturer at the University of Worcester and Associate member of EAU Guidelines Panel on Muscle Invasive and Metastatic Bladder Cancer.
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