Neurosurgeons in London have successfully performed what is being described as the world’s first live, artificial intelligence-assisted operation to remove a brain tumour.
The procedure was carried out earlier this year at the National Hospital for Neurology and Neurosurgery (NHNN) in London on 48-year-old Rhys Hibbert, who was at risk of losing his sight without surgery.
Unlike conventional approaches that rely primarily on scans taken before an operation, the AI system analysed a live video feed from the surgery in real time.
The surgeons remained fully in control throughout the procedure, while the technology helped them make more precise decisions by identifying and highlighting critical structures at the base of the brain.
The operation, performed in May, marked the first time the technology had been used on a patient in this way. Details were kept private until now to allow Hibbert time to recover.
The pituitary gland sits in an area where blood vessels and nerves responsible for vision are packed closely together. Even a millimetre of error can have serious consequences, including blindness, stroke or death.
The surgical team therefore used AI to help identify areas that posed a risk while allowing them to remove as much of the tumour as safely possible.
The system can also track surgical instruments and interactions between instruments and tissue, providing real-time feedback to support surgeons during complex procedures.
The operation was performed by a team at the NHNN, which is part of University College London Hospitals NHS Foundation Trust (UCLH). It formed part of a clinical trial involving AI technology developed in-house at University College London (UCL) and funded by the National Institute for Health and Care Research (NIHR) and Google.
Before the operation, researchers trained and evaluated the system using a large collection of annotated videos from previous endoscopic pituitary surgeries. By learning from hundreds of procedures, the AI was trained to recognise critical anatomy, surgical instruments and interactions with tissue.
Hani Marcus, a consultant neurosurgeon at the NHNN and professor of neurosurgery at the UCL Queen Square Institute of Neurology, performed the AI-assisted operation alongside Danyal Khan, the surgical resident leading the work.
Marcus said the procedure represented an important global first and thanked the trial participants and the multidisciplinary team behind the project.
“Huge thanks to the trial participants and to the team committed to improving patient outcomes by taking this important first step globally and using UK homegrown AI to help reduce risk during these delicate surgeries.”
Sophia Bano, associate professor of robotics and AI at UCL and technical lead for the system, said the technology was designed to support, rather than replace, surgeons.
“This AI system was developed by a multidisciplinary team at UCL. By learning from hundreds of surgical videos, it has been exposed to a breadth of surgical examples that would take a surgeon many years to encounter.”
She added that the system was designed to recognise critical anatomy, surgical instruments and tissue interactions in real time, providing additional support during highly delicate procedures.
Mike Lewis, NIHR scientific director for innovation, described the operation as a pioneering example of how advanced AI could support surgeons and improve patient care.
“By investing in innovative digital technologies, the NIHR is helping to turn cutting edge research into practical tools that can make a real difference in the operating theatre,” he said.
The National Hospital for Neurology and Neurosurgery was founded in 1859 and is recognised as the world’s first dedicated neurosurgical hospital.
“So, to me, it seems very fitting that the same hospital should also be the world’s first to carry out an AI assisted neurosurgery,” Hibbert said.
“I’m very pleased to have had the opportunity to be cared for in the hospital. I’m also very humbled to have been asked if I’ll be prepared to be the world’s first patient in this research.”
The Society of British Neurological Surgeons also welcomed the development, describing the use of AI as an “exciting and encouraging” example of how advanced technologies could support clinical decision-making and surgical planning.
A spokesperson said the society supports innovation that could improve the safety, precision and outcomes of neurosurgical care, while stressing that new approaches must undergo careful evaluation.
The spokesperson added that developments such as this demonstrate the growing potential for AI to augment, rather than replace, the expertise and judgment of highly trained neurosurgical teams
