The first use of Artificial Intelligence to support a neurosurgeon in real time during live surgery has protected the sight of a man having a brain tumour removed.
The operation was carried out at the National Hospital for Neurology and Neurosurgery (NHNN), UCLH, as part of a clinical trial using AI technology developed in-house at UCL and funded by the National Institute for Health and Care Research (NIHR).
Rhys Hibbert aged 48 from Bedfordshire, a Customer Services Manager and active Community Volunteer, is the first patient to have surgery in this way. Without surgery, Rhys’ tumour would have continued to threaten his sight and could ultimately have led to blindness. The operation successfully removed the tumour and protected his vision.
During his operation, the AI analysed the live surgical video feed in real time, rather than using pre-surgery scans, to help the surgical team make more precise decisions by highlighting critical structures at the base of the brain.
In this part of the brain, the pituitary gland (the size of a marble), blood vessels and nerves controlling vision are tightly packed together, and going a millimetre wrong can make a critical difference and lead to death, blindness or stroke. The AI supported the surgical team helping identify risky areas to avoid while removing as much tumour as safely possible. It also has the potential to track surgical instruments and instrument–tissue interactions, with the aim of supporting surgeons during complex procedures and providing feedback.
Rhys said learning and research is very important to him and described the experience as both “humbling” and “fitting” for a hospital with a long record of medical innovation.
“The National Hospital for Neurology and Neurosurgery was founded in 1859… and was the world's first dedicated neurosurgical hospital. So to me, it seems very fitting that the same hospital should also be the world's first to carry out an AI‑assisted neurosurgery.”
“I'm very pleased to have had the opportunity to be cared for in the hospital… I'm also very humbled to have been asked if I'll be prepared to be the world's first patient in this research.”
James Frith, Health Innovation Minister, said: “This is an example of AI at its best: patients getting care previously deemed unimaginable thanks to the latest groundbreaking technology.
“I am so pleased for Rhys that he had this life-changing surgery as part of government-funded research that will pave the way for the treatments of tomorrow.
“AI needs proper safeguards and we will always ensure that safety is taken seriously. But we will also ensure we benefit from the opportunities it brings to deliver faster and more effective care. That is what we mean by building an NHS that is fit for the future.”
Hani Marcus consultant neurosurgeon at the NHNN, UCLH and a professor of neurosurgery at the UCL Queen Square Institute of Neurology performed this first AI assisted surgery alongside Danyal Khan, the surgical resident leading the work.
Hani said: “Huge thanks to the trial participants and to the team committed to improving patient outcomes by taking this important first step globally and using UK homegrown AI to help reduce risk during these delicate surgeries.”
The AI system was developed at the UCL Hawkes Institute, a multidisciplinary research group at UCL focused on advancing healthcare technologies. The system runs on an NVIDIA Clara IGX platform designed to support real-time AI in medical device settings.
Researchers trained and evaluated the system using a large collection of annotated endoscopic pituitary surgery videos from previous operations. The technology has previously been evaluated and used as a training tool for surgeons carrying out this procedure.
Dr Sophia Bano, Associate Professor in Robotics and Artificial Intelligence at UCL Computer Science and the UCL Hawkes Institute, who is technical lead for the AI system, said: “This AI system was developed by a multidisciplinary team at UCL. By learning from hundreds of surgical videos, it has been exposed to a breadth of surgical examples that would take a surgeon many years to encounter. It is designed to help recognise critical anatomy, surgical instruments and tissue interactions in real time, supporting the surgeon during highly delicate procedures.”
The trial was funded by NIHR and Google. It was supported by the NIHR Biomedical Research Centre: UCLH, Royal College of Surgeons, Engineering and Physical Sciences Research Council and Wellcome.
Professor Mike Lewis, NIHR Scientific Director for Innovation, said: “This pioneering surgery highlights the potential of advanced AI to support surgeons and improve patient care. By investing in innovative digital technologies, the NIHR is helping to turn cutting-edge research into practical tools that can make a real difference in the operating theatre.
"This work reflects the ambitions of the government’s 10 Year Health Plan to harness innovation and technology to improve healthcare, and it is exciting to see these advances providing surgeons with valuable real-time support during complex procedures.”
