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Villavisanis et al. Art Int Surg. 2025;5:133-38 Artificial
DOI: 10.20517/ais.2024.89
Intelligence Surgery

Review Open Access

Artificial intelligence applications in free flap
microvascular reconstruction: preoperative

planning, intraoperative assessment, and
postoperative monitoring

Dillan F. Villavisanis, Sharbel A. Elhage, Dustin T. Crystal, Peyton Terry, Joseph M. Serletti, Ivona Percec

Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA 19103, USA.
Correspondence to: Dr. Ivona Percec, Division of Plastic Surgery, Department of Surgery, University of Pennsylvania,
3401 Spruce Street, Philadelphia, PA 19103, USA. E-mail: Ivona.Percec@pennmedicine.upenn.edu
How to cite this article: Villavisanis DF, Elhage SA, Crystal DT, Terry P, Serletti JM, Percec I. Artificial intelligence applications in
free flap microvascular reconstruction: preoperative planning, intraoperative assessment, and postoperative monitoring. Art Int
Surg. 2025;5:133-38. https://dx.doi.org/10.20517/ais.2024.89

Received: 9 Oct 2024 First Decision: 1 Dec 2024 Revised: 17 Dec 2024 Accepted: 9 Jan 2025 Published: 4 Mar 2025
Academic Editor: Ulf Dietrich Kahlert Copy Editor: Ting-Ting Hu Production Editor: Ting-Ting Hu

Abstract
Reliable planning, execution, and postoperative monitoring in microvascular free flap reconstruction are essential
to optimize clinical outcomes. Artificial intelligence has demonstrated value in several applications to clinical
medicine and surgery, including image analysis and simulation, outcomes modeling, and evaluation of large
datasets. Within microvascular reconstruction, artificial intelligence has been increasingly applied to preoperative
planning, intraoperative decision making, and postoperative monitoring. The present paper aims to review salient
applications to each. The authors conclude by suggesting areas suitable for future analysis.

Keywords: Artificial intelligence, free flap, microvascular reconstruction, anastomosis

INTRODUCTION
Reliable preoperative planning, intraoperative assessment, and postoperative monitoring in free flap
[1,2]
microvascular are essential to guarantee successful long-term reconstructive outcomes . Clinical
examination during the pre-, intra-, and postoperative periods remains the gold standard of assessment for

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
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