{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:04:17Z","timestamp":1789819457656,"version":"4.0.1"},"reference-count":29,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Addressing intraoperative bleeding remains a significant challenge in the field of robotic surgery. This research endeavors to pioneer a groundbreaking solution utilizing convolutional neural networks (CNNs). The objective is to establish a system capable of forecasting instances of intraoperative bleeding during robot-assisted radical prostatectomy (RARP) and promptly notify the surgeon about bleeding risks. Methods: To achieve this, a multi-task learning (MTL) CNN was introduced, leveraging a modified version of the U-Net architecture. The aim was to categorize video input as either \u201cabsence of blood accumulation\u201d (0) or \u201cpresence of blood accumulation\u201d (1). To facilitate seamless interaction with the neural networks, the Bleeding Artificial Intelligence-based Detector (BLAIR) software was created using the Python Keras API and built upon the PyQT framework. A subsequent clinical assessment of BLAIR\u2019s efficacy was performed, comparing its bleeding identification performance against that of a urologist. Various perioperative variables were also gathered. For optimal MTL-CNN training parameterization, a multi-task loss function was adopted to enhance the accuracy of event detection by taking advantage of surgical tools\u2019 semantic segmentation. Additionally, the Multiple Correspondence Analysis (MCA) approach was employed to assess software performance. Results: The MTL-CNN demonstrated a remarkable event recognition accuracy of 90.63%. When evaluating BLAIR\u2019s predictive ability and its capacity to pre-warn surgeons of potential bleeding incidents, the density plot highlighted a striking similarity between BLAIR and human assessments. In fact, BLAIR exhibited a faster response. Notably, the MCA analysis revealed no discernible distinction between the software and human performance in accurately identifying instances of bleeding. Conclusion: The BLAIR software proved its competence by achieving over 90% accuracy in predicting bleeding events during RARP. This accomplishment underscores the potential of AI to assist surgeons during interventions. This study exemplifies the positive impact AI applications can have on surgical procedures.<\/jats:p>","DOI":"10.3390\/jcm12237355","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T07:41:32Z","timestamp":1701157292000},"page":"7355","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Development of Bleeding Artificial Intelligence Detector (BLAIR) System for Robotic Radical Prostatectomy"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7901-5608","authenticated-orcid":false,"given":"Enrico","family":"Checcucci","sequence":"first","affiliation":[{"name":"Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2288-8410","authenticated-orcid":false,"given":"Pietro","family":"Piazzolla","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Politecnico di Milano, 20156 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2359-4409","authenticated-orcid":false,"given":"Giorgia","family":"Marullo","sequence":"additional","affiliation":[{"name":"Department of Management, Production, and Design Engineering, Polytechnic University of Turin, 10129 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7839-6218","authenticated-orcid":false,"given":"Chiara","family":"Innocente","sequence":"additional","affiliation":[{"name":"Department of Management, Production, and Design Engineering, Polytechnic University of Turin, 10129 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Salerno","sequence":"additional","affiliation":[{"name":"Department of Management, Production, and Design Engineering, Polytechnic University of Turin, 10129 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8407-0660","authenticated-orcid":false,"given":"Luca","family":"Ulrich","sequence":"additional","affiliation":[{"name":"Department of Management, Production, and Design Engineering, Polytechnic University of Turin, 10129 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5097-7344","authenticated-orcid":false,"given":"Sandro","family":"Moos","sequence":"additional","affiliation":[{"name":"Department of Management, Production, and Design Engineering, Polytechnic University of Turin, 10129 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Quar\u00e0","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Volpi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5425-5453","authenticated-orcid":false,"given":"Daniele","family":"Amparore","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Piramide","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Turcan","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Garzena","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4997-5209","authenticated-orcid":false,"given":"Davide","family":"Garino","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"De Cillis","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4166-1468","authenticated-orcid":false,"given":"Michele","family":"Sica","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3662-6828","authenticated-orcid":false,"given":"Paolo","family":"Verri","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9247-7938","authenticated-orcid":false,"given":"Alberto","family":"Piana","sequence":"additional","affiliation":[{"name":"Romolo Hospital, Rocca di Neto (KR), 88821 Rocca di Neto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8003-9201","authenticated-orcid":false,"given":"Lorenzo","family":"Castellino","sequence":"additional","affiliation":[{"name":"Department of Chemistry, University of Turin, 10124 Torino, Italy"},{"name":"Antidoping Center \u201cA. Bertinaria\u201d, 10060 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Alba","sequence":"additional","affiliation":[{"name":"Romolo Hospital, Rocca di Neto (KR), 88821 Rocca di Neto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3227-5573","authenticated-orcid":false,"given":"Michele","family":"Di Dio","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, SS Annunziata Hospital, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Fiori","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Alladio","sequence":"additional","affiliation":[{"name":"Department of Chemistry, University of Turin, 10124 Torino, Italy"},{"name":"Antidoping Center \u201cA. Bertinaria\u201d, 10060 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Vezzetti","sequence":"additional","affiliation":[{"name":"Department of Management, Production, and Design Engineering, Polytechnic University of Turin, 10129 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Porpiglia","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.eururo.2016.08.003","article-title":"EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent","volume":"71","author":"Mottet","year":"2017","journal-title":"Eur. 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