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The OR black box in urology: A survey on patient acceptance and confidence in AI-assisted surgery

Objectives This study aims to assess patient acceptance of intraoperative video recording with Operating Room (OR) black box technology, characterise consent conditions and use-case preferences, and identify predictors of patient confidence in artificial intelligence (AI)-assisted surgery in urological patients. Patients and methods This prospective cross-sectional survey was conducted at the urology department of a university hospital from March 2024 to March 2025. Consecutive adults scheduled for elective proc…

By the Truvace desk2 min read1 sourcePeer-reviewedTRV-2026-1355· cite & verify
The OR black box in urology: A survey on patient acceptance and confidence in AI-assisted surgery
United States Naval Medical Bulletin, Vol. 41, Nos. 1-6, 1943 by U.S. Navy. Bureau of Medicine and Surgery. Public domain

In brief

A prospective cross-sectional survey at a university hospital urology department ran from March 2024 to March 2025 and enrolled 322 adults scheduled for elective procedures. Patients answered a 29-item questionnaire about consenting to video storage of their operations and about their attitudes toward AI in surgery. Nearly all of the 316 who answered the consent question agreed, and every oncological patient did.

The findings suggest patients may be receptive to operating room black box systems if consent and data governance are handled openly, and that individual attitudes matter more than age or diagnosis. Confidence was far lower for AI across a full procedure than acceptance of recording, and the single-center sample was mostly male and older, so wider applicability remains unclear.

Main points

  1. Of 316 patients answering the consent item, 304 (96.2%) agreed to operative video storage.
  2. All 181 oncological patients consented, while the 12 nonconsenters were younger, had no oncological diagnosis and reported lower AI confidence.
  3. Confidence in AI-assisted surgery was 55.2% for the full procedure, 63.5% for simple steps and 53.9% for complex steps.
  4. Demographic and clinical characteristics explained only 5.8% of variation in confidence, with attitudinal factors explaining much more.

The gain

In a hospital survey, 96.2% of urological patients consented to operative video storage for OR black box use, and a majority endorsed AI-assisted surgery when governance is transparent.

The rundown

The study enrolled consecutive adults scheduled for elective urological procedures; 82.9% were male with a mean age of 65.4 years. The questionnaire covered consent conditions, use cases, data access and AI confidence across four Likert-scaled domains.

The primary outcome was confidence in AI-assisted surgery for the full procedure. Analysis used Wilson confidence intervals, group comparisons and multivariable linear regression, and all 29 attitudinal items received majority endorsement.

Patients were more confident in AI for simple steps than for complex ones. The authors conclude that attitudinal factors outweigh demographic and clinical ones, supporting patient-centred consent frameworks for implementing OR black boxes in urology.

Sources

  1. Peer-reviewedBJUI Compass2026-10-02

The debate