Smarter Surgery in Urology: Real-World Applications of Artificial Intelligence Across the Procedural Pathway

Artificial intelligence (AI) tools are moving rapidly from research prototypes into real urological practice, spanning imaging, robotic and endoscopic surgery, diagnostics, and perioperative decision support. Despite this expansion, adoption across the actual procedural pathway, from preoperative planning through intraoperative guidance to postoperative management surveillance, remains uneven and inconsistently validated. Much of the current literature emphasizes algorithmic performance rather than real‑world safety, robustness, and impact on patient outcomes and surgical workflows.This special issue aims to bring together a discussion on real‑world evidence on how applied AI in urological surgery; is being applied its penetration, and how it should be evaluated across the full urological procedural journey. We particularly welcome work that prioritizes clinical usefulness, safety, validation, and implementation over algorithm novelty alone, with clear links to patient outcomes, complication profiles, functional results, and OR performance. Central to this collection are studies that demonstrate external validation, generalizability, usability, and workflow integration, rather than algorithmic performance in isolation. It is this combination of technical innovation and real-world clinical implementation that distinguishes this Research Topic from more general AI-focused collections.Discussions of AI scope, overreach, and status of and need for AI guardrails are also welcomed in the context of surgical patient safety and trust in this technology.We invite original research (clinical trials, observational cohorts, registry analyses, implementation studies, technical‑clinical hybrid papers, and proof of concept), systematic reviews and meta‑analyses, methods papers, and perspectives and commentaries on ethical, regulatory, and organizational aspects of AI deployment, including surgeon, trainee, and patient experiences. Submissions may address, but are not limited to, AI applications in:- Preoperative planning and surgical strategy- Imaging‑based tumor characterization, segmentation, and 3D modeling for robotic uro‑oncologic procedures- Imaging‑based stone characterization and treatment planning for endourological procedures- ML‑driven risk stratification and prediction of perioperative complications, functional outcomes, and resource utilization.- Intraoperative computer vision and robotics- Real‑time anatomical recognition, step recognition, and safety alerts during urology procedures- AI‑assisted 3D and augmented reality platforms for navigation, margin assessment, and intraoperative decision support- Postoperative outcome and complication prediction- AI‑based surgical training and performance assessment- Governance, medico‑legal, and regulatory frameworks for AI‑enabled imaging, robotics, and decision support systems in urologyTopic Editor Dr. Francesco Prata is a consultant for Medtronic. Topic Editor Dr. Giovanni Cacciamani holds equity in EditorARPro. There are no other reported competing interests related to this Research Topic. Topic editors: Alex Qinyang Liu, Giovanni Cacciamani, Francesco Prata Source: https://www.frontiersin.org/research-topics/83790/smarter-surgery-in-urology-real-world-applications-of-artificial-intelligence-across-the-procedural-pathway