Artificial intelligence and robotic surgery in emergency gastrointestinal procedures: a review of current evidence and future directions.

Gastrointestinal emergency surgeries have a high rate of morbidity and mortality due to diagnostic inaccuracies, urgent decision-making, and physiological instability of patients. While robotic surgery and artificial intelligence (AI) have become well-established in elective procedures, their application in emergency gastrointestinal surgery remains an emerging field. This study is presented as a narrative review due to the heterogeneity of available study designs, study populations, the used technologies and reported outcomes. A literature search was performed across relevant databases. Data were summarized narratively across key areas, including emergency triage, predictive analytics for sepsis and postoperative complications, preoperative planning, intraoperative AI-assisted anatomical recognition, and clinical outcomes. Current evidence indicates that robotic surgery is feasible and safe in selected emergency gastrointestinal conditions, such as acute cholecystitis, perforated peptic ulcers, and diverticulitis. AI technologies have shown promise in improving diagnostic accuracy and decision-making during surgical procedures. However, widespread adoption is limited by high costs, institutional requirements, and concerns regarding algorithm transparency. In conclusion, AI-assisted robotic surgery shows considerable potential to enhance outcomes in emergency gastrointestinal surgery. Nevertheless, further validation and structured implementation are necessary before routine clinical adoption.