The use of artificial intelligence and wearable devices in enhanced recovery after surgery pathways following radical cystectomy: a systematic review

Objective

Radical cystectomy is associated with relatively high rates of 90-day complications (58%–66%) and readmission (40%). The increasing availability of wearable devices, such as Fitbit devices, Misfit trackers and SenseWear armbands, may offer opportunities to improve postoperative outcomes. This review aimed to explore the roles of wearable devices and artificial intelligence in the perioperative care of patients undergoing radical cystectomy.

Methods

A systematic review (PROSPERO: CRD420261279062) was conducted to investigate the role of wearable devices and artificial intelligence in enhanced recovery protocols following radical cystectomy. A total of 1031 studies were identified from 5 databases, of which 42 underwent full-text screening. Following final eligibility assessment, eight studies were included in the systematic review. Extracted postoperative outcomes included step count, length of stay, readmission, discharge location, body mass index, functional measures and postoperative complications.

Results

Seven studies investigated wearable devices, whereas one study examined the use of artificial intelligence to assess the association between body composition and postoperative complications. Preliminary evidence suggested that wearable devices improve postoperative physical activity and step counts; however, the significance of these associations varied substantially across studies. Evidence regarding artificial intelligence was limited to preoperative planning but indicated potential for identifying patients at high or low risk of complications following radical cystectomy.

Conclusions

Preliminary evidence suggests that wearable devices and artificial intelligence provide useful information to support postoperative recovery. However, the limited number of studies precludes firm conclusions. Randomised trials using standardised parameters are needed to establish the roles of wearable devices and artificial intelligence before their clinical integration into established enhanced recovery after surgery protocols.