Table 2.

Underexplored AI applications in pediatric surgery compared to adult surgery

Area of application	Status in adult surgery	Status in pediatric surgery	Challenge
AI-guided preoperative risk stratification	Widely used (e.g., LOS prediction)	Limited tools; rare data registries and small cohorts	Lack of large pediatric datasets; condition heterogeneity
AI-Enhanced Surgical Robotics and Autonomy	Limited clinical use used in urology, colorectal with AI-driven tasks	Minimal use	Size constraints, regulatory barriers, lack of pediatric-specific platforms
AI for Intraoperative Decision Support (e.g., computer vision)	Experimental phase (e.g., structure recognition)	Largely unexplored; no pediatric datasets or validated tools	Few annotated surgical videos; case rarity
AI in Postoperative Complication Prediction/Long-term outcomes	Widely used to predict infection, readmission, bleeding risks, QoL	Limited tools; mostly in research phase	Lack of integrated perioperative data systems for children
NLP for Operative Notes and Clinical Documentation	Used for quality control, adverse event detection, auto-documentation	Rare use in pediatrics; models not adapted to pediatric language	Need for pediatric-specific ontologies
AI in Surgical Education and Simulation	AI-enhanced simulators, skill tracking, rare case training available	Very limited; few pediatric-specific simulators with AI	Case complexity, limited training datasets