Artificial intelligence for instance segmentation of MRI: advancing efficiency and safety in laparoscopic myomectomy of broad ligament fibroids.

BACKGROUND

Uterine broad ligament fibroids present unique surgical challenges due to their proximity to vital pelvic structures. This study aimed to evaluate artificial intelligence (AI)-guided MRI instance segmentation for optimizing laparoscopic myomectomy outcomes.

METHODS

In this trial, 120 patients with MRI-confirmed broad ligament fibroids were allocated to either AI-assisted group (n=60) or conventional MRI group (n=60). A deep learning model was developed to segment fibroids, uterine walls, and uterine cavity from preoperative MRI.

RESULT: Compared to conventional MRI guidance, AI assistance significantly reduced operative time (118 [112.25-125.00] vs. 140 [115.75-160.75] minutes; p<0.001). The AI group also demonstrated lower intraoperative blood loss (50 [50-100] vs. 85 [50-100] ml; p=0.01) and faster postoperative recovery (first flatus within 24 hours: (15[25.00%] vs. 29[48.33%], p=0.01).

CONCLUSION

This multidisciplinary AI system enhances surgical precision through millimeter-level anatomical delineation, demonstrating transformative potential for complex gynecologic oncology procedures. Clinical adoption of this approach could reduce intraoperative blood loss and iatrogenic complications, thereby promoting postoperative recovery.