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Mari et al. Art Int Surg 2022;2:122-31 https://dx.doi.org/10.20517/ais.2022.12 Page 126

be a feasible tool for the evaluation of RAS skills and credentialing of RAS surgeons, allowing them to obtain
[74]
an objective assessment of technical skills that are not prejudiced by the surgeon’s gender . The
development of simulators for RAS is only beginning, and technological improvement may permit the
development of cheaper and better systems in the future.

AI may have further employment in supporting female surgeon training and facilitating their surgical
career, by facing gender barriers and disparity.

AI is useful even during the selection process of surgical residency programs. Sarraf et al. demonstrated that
AI with NLP can identify linguistic differences and gender disparity in letters of recommendation for
general surgery residency applicants . AI could detect implicit biases in female applicants’ selection and
[75]
thus avoid them, in order to obtain equal resident selection.

During surgical training, the importance of one-on-one mentoring was demonstrated for female trainees,
[10]
who were shown to be particularly receptive to this kind of approach . The integration of AI and robotic
surgery could be employed to provide remote surgical mentoring and training to surgical residents,
transferring surgical skills and knowledge. Telerobotic surgery has firmly demonstrated the feasibility and
clinical safety of remote telementoring in surgery [76-78] . Telementoring has been tested as a training method
for several laparoscopic procedures, such as cholecystectomy , adrenalectomy , colon surgery , and
[79]
[81]
[80]
[82]
bariatric surgery . However, more studies are needed to confirm the same effectiveness of telementoring as
an educational intervention compared to on-site mentoring . However, telementoring has already been
[83]
[84]
successfully used in surgical training in rural areas of Canada . Moreover, it may have a role in extending
the possibility of training surgical residents in low-and middle-income countries, reducing the significant
limitations due to travelling .
[85]
Promising perspectives also seem to be offered by robotic telementoring. For instance, it has been shown
that telerobotic-assisted colorectal surgery is feasible and safe for patients, and it is an effective tool for
[86]
supporting surgeons during the learning curve . Similar evidence was provided in neurosurgery by
Mendez et al., who completed six long-distance robotic-assisted telementoring neurosurgical procedures .
[87]
Thus, robotic-assisted telementoring could also potentially facilitate the teaching of advanced surgical skills
worldwide.

For female trainees, telementoring could also allow communicating remotely with same-sex role models
and obtaining mentoring and counselling, even in centers with few female surgeons who can fit this role.
This approach could not only help women to improve their surgical technical skills but also help raise
awareness of gender issues and how to deal with them during surgical training .
[88]
Similar to how virtual reality and robotic surgery can be used to train surgeons at work, this solution may be
used for trainees on maternity leave to continue their training and avoid losing their technical skills. Cost,
size of the machine, and limited functionality are problematic, which might be eliminated or reduced by
developing new technologies. Therefore, the possibility provided by AIS to train anywhere and anytime
with virtual reality and simulators in surgery could significantly contribute to ameliorating female surgeons’
work–life balance issues .
[89]
The positive effect of AI on training, education, and remote mentoring could favorably impact the choice of
young women to pursue a surgical career. AI could help female surgical trainees in facing many of the
above-mentioned obstacles, so they would not be forced to choose between their careers and personal life.