During the Surgical AI & Telesurgery Days in Ghent, Orsi Academy presented what it claims to be a world first: an AI co-pilot that supports surgeons in real time during robotic surgery. The technology was demonstrated live and marks a new step in the clinical application of artificial intelligence in the operating room.
According to CEO Prof. Dr. Alex Mottrie, the innovation is not a future scenario, but a concrete solution that can be put into practice. The AI co-pilot analyzes the surgical images live, automatically recognizes surgical phases, detects critical anatomical structures, and provides contextual support for complex surgical decisions. In this way, the system contributes to greater precision, improved patient safety, and a more efficient workflow.
From proof-of-concept to clinical integration
The technology was developed by the Orsi Innotech team led by Pieter De Backer, urologist and engineer. In 2023, the team achieved an international first by simultaneously deploying four AI models during a robot-assisted kidney operation. This combination of real-time organ recognition, automatic phase detection, image anonymization, and augmented reality visualization made it possible to remove a kidney tumor without clamping off the blood supply to the kidney. This is an important step forward in organ preservation and safety.
With the introduction of an integrated AI co-pilot, the focus is now shifting from experimental applications to broader clinical support across the entire surgical process: from preoperative planning and instrument selection to intraoperative guidance and training.
Supercomputing in the operating room
For further development, Orsi was selected as one of the first medical applications worldwide on the NVIDIA supercomputer, designed for extreme real-time computing power in critical environments. This infrastructure enables complex AI models to function without delay during surgical procedures.
The technology was tested live during a robotic surgery at AZORG Hospital, with the procedure streamed in real time to the conference in Ghent.
With this development, Belgium is positioning itself at the forefront of AI-driven surgery internationally. At the same time, the innovation raises questions about validation, regulatory frameworks, and integration into existing healthcare processes. These are issues that will determine large-scale implementation in the coming years.
Remote surgery
In recent years, AZORG Hospital has pioneered robot-assisted surgeries performed remotely. In May 2025, for example, two telesurgery operations were performed, which the hospital claims were the first of their kind in Europe.
The first operation was performed by Dr. Geert De Naeyer from the Orsi Academy in Merelbeke, while the patient was at the AZORG hospital in Aalst. The second procedure was led by Dr. Emily Jamaer, a gynecologist at AZORG, who was the first female surgeon in Europe to perform a hysterectomy via telesurgery. Both operations were performed using the Toumai Tele-Robotic Surgical System.
Earlier this year, research from a controlled trial, conducted in China, concluded that remote surgery s as reliable as conventional on-site robotic surgery. The study included 72 patients with kidney tumours or prostate cancer treated across five hospitals. Participants were randomly assigned to either telesurgery or local robotic procedures. Ultimately, 32 underwent telesurgery and 31 received local surgery.
Results showed no significant differences in success rates, complications, blood loss, recovery, oncological outcomes or surgical team workload. The telesurgery system operated stably over distances of 1,000 to 2,800 kilometres. All surgeons were highly experienced, each having performed over 500 robotic procedures.
