The operating room is entering a period of extraordinary transformation. Robotics, artificial intelligence, minimally invasive techniques, advanced imaging, simulation, and digital data are rapidly changing the way surgeons prepare for, perform, and evaluate operations. This technological revolution raises a fascinating question: if machines become increasingly capable of assisting surgeons, what happens to the traditional art of surgery?

This question formed the central theme of “Is Surgery a Dying Art?”, presented at WALS 2025. The WALS scientific program placed the presentation by Dr. Praveen Bhatia within a keynote session that also explored surgery in the digital era, AI in robotic surgery, and the transition from scalpel to software.

Rather than representing the disappearance of surgery, these developments point toward a fundamental transformation in what it means to be a surgeon.

From the Surgeon’s Hand to the Digital Operating Room

For centuries, surgery depended heavily on the surgeon's hands.

Anatomical knowledge had to be combined with tactile feedback, manual dexterity, visual judgment, and experience. Surgeons learned how tissues felt, how they responded to traction, and how to recognize subtle changes that could influence an operation.

Minimal access surgery changed this relationship between the surgeon and the patient's anatomy.

Instead of placing the surgeon's hands directly into the operative field, laparoscopic surgery introduced cameras, long instruments, monitors, and indirect visualization. Surgeons had to develop new forms of hand-eye coordination and spatial awareness.

Robotic surgery took this transformation further by introducing articulated instruments, enhanced visualization, and computer-mediated movement.

The result is not less surgical skill—it is a different type of surgical skill.

Robotics as an Extension of the Surgeon

Robotic systems are often misunderstood as autonomous machines that perform operations independently.

In contemporary robotic surgery, the surgeon remains responsible for planning and controlling the procedure. The robotic system functions as an advanced interface between surgeon and patient.

This distinction is critical.

The robot can provide technological advantages such as enhanced visualization, instrument articulation, and movement scaling, but it does not independently assume the ethical and clinical responsibility of the surgeon.

This creates an important concept for the future: robotics should be viewed as an extension of surgical capability rather than a replacement for surgical judgment.

Artificial Intelligence as a Surgical Partner

Artificial intelligence introduces another dimension.

AI can analyze enormous quantities of information far faster than an individual human can. In surgery, this capability could potentially support imaging interpretation, anatomical recognition, risk prediction, surgical planning, and postoperative monitoring.

Imagine a future operating room where the surgeon has immediate access to an integrated digital representation of the patient's anatomy, previous imaging, relevant clinical history, and real-time intraoperative information.

Such technology could help identify important structures or highlight potential risks.

But the surgeon would still need to decide whether the AI-generated information is relevant and how it should influence the operation.

The ability to question technology may become just as important as the ability to use it.

What Happens to Traditional Surgical Skills?

This is one of the most important educational questions raised by technological advancement.

If future surgeons learn primarily through robotic systems, could traditional open surgical skills gradually decline?

There is legitimate concern that excessive technological dependence could make surgeons less prepared for unexpected situations, particularly when equipment fails or when a procedure must be converted to an alternative approach.

For this reason, future surgical training should not abandon foundational knowledge.

Surgeons should understand open surgery, laparoscopic surgery, robotic surgery, anatomy, physiology, emergency management, and complication control.

Technology should expand the surgeon's capabilities rather than narrow them.

Surgical Education in the Digital Era

Training is likely to become one of the areas most affected by the digital transformation.

Virtual reality can allow trainees to rehearse procedures before entering the operating room. Robotic simulators can help develop instrument-control skills. AI-assisted platforms may eventually provide individualized feedback on technical performance.

These tools can make education more structured and measurable.

Instead of simply asking whether a trainee has “performed enough procedures,” educators may increasingly assess objective indicators such as precision, efficiency, tissue handling, decision-making, and complication management.

However, no simulator can completely reproduce the complexity of treating a real patient.

Surgical education must therefore maintain the human relationship between mentor and trainee.

The Importance of the Human Touch

Perhaps the most difficult element for technology to reproduce is the human connection between surgeon and patient.

Patients do not simply need technically accurate procedures. They need someone who can explain the diagnosis, discuss uncertainty, understand their fears, describe alternatives, and take responsibility for difficult decisions.

A surgeon must sometimes tell a patient that an operation should not be performed.

That decision requires more than an algorithm.

It requires clinical judgment, ethics, communication, and an understanding of the individual's goals.

The future of surgical excellence must therefore preserve the human side of medicine even as technology becomes increasingly sophisticated.

Digital Surgery and Patient Safety

Technology can potentially improve safety by providing surgeons with better information, but it can also introduce new forms of risk.

Equipment failure, software errors, inaccurate AI predictions, cybersecurity concerns, data-quality problems, and excessive dependence on automated systems all require careful consideration.

Surgeons must therefore develop technological situational awareness.

They should understand the capabilities and limitations of the systems they use and maintain the ability to continue safely when technology is unavailable.

This principle is particularly important in high-stakes environments where a delay caused by technical failure could have serious consequences.

Accessibility and the Cost of Innovation

Another challenge is access.

Robotic systems, advanced imaging, AI platforms, simulation centers, and specialized training programs require substantial investment. Their availability can differ dramatically between hospitals and countries.

If technological advances are accessible only to wealthy healthcare systems, the benefits of digital surgery may not reach the broader population.

Therefore, the future of surgical innovation should include efforts to make advanced technologies affordable, scalable, and accessible.

The goal should not simply be to create the most sophisticated operating room possible. It should be to improve surgical care for as many patients as possible.

The Surgeon of Tomorrow

The surgeon of the future may look very different from the traditional image of a surgeon.

Technical expertise will remain essential, but it will be combined with knowledge of robotics, AI, data analysis, imaging, simulation, and digital systems.

Future surgeons may need to understand not only how to perform an operation but also how algorithms are trained, how data can be biased, how AI recommendations should be validated, and when technology should not be trusted.

This creates a new professional identity: the surgeon-technologist.

Preserving the Art While Embracing Science

The debate over whether surgery is a dying art should perhaps be reframed.

The art of surgery has never been limited to the movement of a scalpel.

It includes judgment, adaptability, anatomy, timing, decision-making, communication, leadership, and responsibility.

Technology does not necessarily destroy these qualities.

Instead, it may allow surgeons to redirect their skills toward more complex forms of decision-making.

A robot may perform a highly precise movement, but the surgeon decides where, when, why, and whether that movement should occur.

AI may identify a possible risk, but the surgeon determines how that information affects the treatment plan.

This is the emerging partnership between human expertise and machine intelligence.

WALS 2025: A Vision of Surgical Transformation

WALS 2025 was built around the theme of recent advances in minimal access and robotic surgery and brought together experts to discuss innovations shaping modern surgical practice. The scientific program included dedicated presentations on surgical ergonomics, digital-era surgery, AI integration in robotic surgery, and the changing relationship between surgery and software.

The “Is Surgery a Dying Art?” discussion therefore represents more than a philosophical question. It is a challenge to surgeons and educators to consider what skills must be preserved and what new skills must be developed.

The answer is not to resist technology.

Nor is it to surrender surgical decision-making to technology.

The future lies somewhere between the two.

Conclusion

Surgery is not a dying art. It is becoming a hybrid discipline in which human expertise and technological intelligence increasingly work together.

The surgeon's hands remain important, but they are now supported by sophisticated instruments. The surgeon's eyes are enhanced by high-definition and three-dimensional visualization. Clinical judgment can be supported by data and AI. Surgical education can be strengthened by simulation.

Yet the responsibility for the patient remains fundamentally human.

The future of surgical excellence will depend on maintaining the timeless principles of anatomy, safety, judgment, compassion, and responsibility while embracing the opportunities provided by robotics, artificial intelligence, and digital medicine.

The most successful surgeons of the future will not be those who choose between traditional surgery and technology. They will be those who understand how to integrate both—preserving the art of surgery while using science and technology to take surgical care to a new level.