E-AHPBA innovation committee position paper on the future of hepato-pancreato and biliary surgery and artificial intelligence

Background: As artificial intelligence (AI) continues to influence surgical practice, its role in Hepato-Pancreato and Biliary (HPB) surgery is becoming increasingly significant. This paper proposes a structured framework for understanding surgical autonomy, with implications for training, departmental organization, and the future of HPB surgery. Methods: An international survey was distributed to 1100 members of the European and African Hepatic Pancreatic and Biliary Association (E-AHPBA). The survey comprised 38 questions, designed by the Innovation Committee and the Artificial Intelligence Surgery Task Force. It assessed surgeon opinions on surgical definitions, technology, and the evolving role of AI. Responses were analyzed for agreement levels, with a level of agreement greater than 75% considered high. Results: A total of 206 responses (18.7%) were collected. There was support for using terms like collaborative robotic surgery (levels 2–4 autonomy) and artificial intelligence surgery (AIS) for levels 2–5. Significant specialty-based differences emerged on some definitions, particularly regarding RAS and autonomy. Conclusion: The future of HPB surgery may require surgeons to be trained not only in traditional and minimally invasive techniques but also AI-assisted interventions. As AI becomes more integral, clear definitions and expanded training are essential to prepare the next generation of HPB surgeons properly.