Enhance Surgical Research Using the Black Box Platform™

AI-driven, ambient technology like the Black Box Platform™ has become an invaluable asset in surgical research,¹ capturing high-fidelity data during procedures,² including videos, audio, and other metrics.  Abiding by each health center’s specific data governance policies, this data is de-identified, securely stored, and made accessible to research teams for analysis. The result? A centralized hub to gather objective, reliable surgical data to address meaningful questions in the operating room. 

Ambient technology provides a standardized way to collect and analyze data, removing guesswork and subjectivity, and offering researchers a foundation for powerful, evidence-based studies. Surgical teams have access to a seamless technological interface that connects procedural insights to research innovation. 

Accelerating Surgical Research

Time and efficiency are central to any successful research project and ambient technology excels in both areas. Traditional research methods often involve labor-intensive manual data collection, but this technology automates the process, dramatically improving data quality and reducing data entry errors. Indexed and tagged video clips allow researchers to locate specific moments within seconds, ensuring that critical insights aren't lost in hours of video footage. 

Ambient technology also brings objectivity to the forefront of surgical research. This unbiased, reproducible data collection platform improves the quality of studies. For instance, a researcher evaluating a new surgical technique can use this platform as a vehicle for standardized reporting metrics across surgical procedures and compare outcomes to established approaches, using consistent video-based benchmarks. The clarity and precision this technology offers makes it an indispensable tool for gathering actionable insights. 

Real-World Applications in Surgical Studies 

The versatility of the Black Box Platform has enabled it to support various types of surgical research. Here are some of its key applications: 

#1 Comparative Studies 

One major use of ambient technology in surgical research is in comparing traditional and novel surgical techniques. Researchers can easily access video data to analyze and break down the specific maneuvers performed during a procedure, capturing granular details of intraoperative conditions and correlating them with clinical outcomes. For example, a study could evaluate the effectiveness of a novel energy device and compare its clinical outcomes to those of other energy devices. With ambient technology, researchers can gain deeper insights into factors such as the duration of device usage, the number of effective burns, and instances of misuse, enabling a more comprehensive analysis of surgical performance and outcomes. 

#2 Procedural Refinement

The granular detail captured by these technologies shines a light on inefficiencies or challenges within specific procedural steps. Video analysis can help pinpoint issues in high-stakes surgeries where complications may arise, enabling teams to reflect and refine their techniques. For example, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recently sponsored a challenge in which researchers studied the achievement of the Critical View of Safety (CVS) process³—an internationally recognized, clinically validated safety check in laparoscopic cholecystectomy to prevent common bile duct injuries—in which AI models were trained to provide surgeons with an automated objective assessment of the CVS, decreasing their cognitive workload, and improving documentation standards, among other applications. This is one of many initiatives underway to use novel computer vision approaches to radically advance surgical performance and safety. 

#3 Surgical Safety and Quality Improvement

Safety and quality are greatly enhanced by providing surgical researchers with the ability to identify and mitigate risks. Surgical teams can adjust protocols to ensure safer outcomes by studying preventable errors or near-misses captured with ambient technology. This platform serves as a valuable tool for high-performance teams engaged in quality improvement initiatives and has no punitive intent. Gaining buy-in from key stakeholders is essential for the successful implementation of the video review process, ensuring its effectiveness in driving meaningful improvements. Video review helps researchers identify a wide variety of intraoperative events, such as technical errors that lead to minor bleeding, thermal injury, and serosal tears.⁴ A solid understanding of the underlying error patterns better prepares surgeons for cases,⁵ reduces the likelihood of adverse outcomes, and improves overall surgical education and quality initiatives. In addition to studying areas for improvement, organizations are using these technologies to deconstruct cases in which care delivery was excellent,⁶ and perpetuate these interactions which lead to optimal outcomes. 

#4 Optimization of Teamwork Dynamics 

Surgical researchers can use ambient technology to study teamwork in the operating room, which is crucial for improving patient safety and optimizing surgical outcomes. Team collaboration allows for effective communication, coordinated actions, quick response to complications, and a shared understanding of the procedure, ultimately minimizing errors and maximizing positive patient results. Healthcare organizations can use this data to design targeted interventions, from surgical training programs⁷ to strategies for enhancing psychological safety and situation assessment, ultimately driving stronger collaboration and better patient outcomes. The OR Black Box® has uncovered how surgical team members adapt their teamwork skills during intraoperative adverse events (IAEs),⁸ highlighting the unique contributions of each role under pressure. Nurses, for example, showed a 5.3x increase in backup behaviors, offering essential support to their colleagues, while surgeons and medical trainees fostered psychological safety to enable open communication and problem-solving—rising 3.6x and 6.6x, respectively, during IAEs. However, all roles expressed fewer situation assessment skills, reflecting the immediate focus on resolving the event. 

#5 Empower Multi-Center Surgical Research Initiatives 

Ambient technology is revolutionizing surgical research collaboration across institutions.⁹ Sharing de-identified video data, after appropriate legal approvals, allows hospitals around the world to share insights while maintaining patient and provider privacy. Multi-center research projects that were once hampered by inconsistencies in data collection now have a unified framework. This fosters pooled analyses and increases the statistical power of studies, enabling AI-driven surgical breakthroughs to be more generalizable. Additionally, this technology supports cross-institutional standardization of surgical techniques. Its extensive indexed library of procedures ensures that surgeons across facilities are trained and evaluated using consistent criteria. The implications for surgical education and research are profound, breaking down geographic barriers, improving patient outcomes, and facilitating the exchange of best practices.¹⁰  

Benefits of Using the Black Box Platform for Surgical Research 

The advantages of integrating ambient technology into surgical research are multifold: 

• Accessible Data. Researchers no longer have to sift through hours of footage or fragmented notes. Indexed and categorized videos make accessing specific case information seamless. 

• Cost and Time Efficiency. The automation of data collection and analysis reduces the resources needed for research. This frees up time for researchers to focus on higher-value tasks. 

• Enhanced Study Reliability. The use of objective, high-quality data improves the credibility of research findings, raising the standard for surgical evidence worldwide.  

Success Stories and What’s Next 

The impact of ambient technology on surgical research is already being realized. Take the example of a study evaluating the effectiveness of a newly developed laparoscopic device.¹¹ The analysis of videos captured across multiple institutions enables researchers to benchmark performance, identify areas of improvement, and refine the tool – all within a fraction of the time that traditional methods would have required. 

Looking ahead, the future of surgical research using the Black Box Platform holds boundless potential. Advancements in artificial intelligence are poised to supercharge the system’s analytics capabilities, enabling predictive modeling and automated performance metrics.  

A New Frontier in Surgical Research

The Black Box Platform is redefining what’s possible in surgical research. The combination of seamless data capture, powerful analytics, and global collaboration is accelerating innovation and improving patient outcomes. The message is clear for surgeons, educators, and researchers alike – embracing ambient technology is a necessity in the pursuit of surgical excellence. 

The revolution is here. The only question now is how far we can all go. 

If you’re interested in learning more about how the Black Box Platform can support your research initiatives, contact us.   

Recommended Reading 

1. Bain, A. P., Holcomb, C. N., Zeh, H. J., et., al. (2024). Artificial intelligence for improving intraoperative surgical care. Global Surgical Education - Journal of the Association for Surgical Education;3(1). https://doi.org/10.1007/s44186-024-00268-z.  

2. Jung, J. J., Jüni, P., Lebovic, G., et., al. (2018). First-year analysis of the Operating room black box study. Annals of Surgery;271(1), 122–127. https://doi.org/10.1097/sla.0000000000002863.  

3. SAGES and CVS Challenge Organizing Board. (2024). The Critical View of Safety Challenge: A SAGES Initiative. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).  https://cvs-challenge.grand-challenge.org/Home/. 

4. Bonrath, E.M., Gordon, L.E., & Grantcharov, T.P., (2015). Characterizing 'near miss' events in complex laparoscopic surgery through video analysis. BMJ Quality & Safety; 24(8), 516-521. https://www.surgicalsafety.com/clinical-research/near-miss-events-complex-laparoscopic-surgery.  

5. Villarreal, J. (2025, January 9). Surgery Videos: Transforming OR Training [Blog]. Surgical Safety Technologies.  https://www.surgicalsafety.com/blog/surgery-videos-transforming-training  

6. Bringing 'black box' technology to the operating room. (2020). UT Southwestern Newsroom: CenterTimes Plus. https://www.utsouthwestern.edu/ctplus/stories/2020/or-black-box.html  

7. Villarreal, J. (2024, November 4). Surgical Video Review: A Gold Mine for New Residents and Fellows [Blog]. Surgical Safety Technologies. https://www.surgicalsafety.com/blog/surgical-video-review-gold-mine-for-new-residents-fellows  

8. Incze, T., Pinkney, S.J., Li, C., et., al. (2024). Using the OR Black Box to Assess Surgical Team Member Adaptation Under Uncertainty: An Observational Study. Annals of Surgery;280(1), 75-81. https://www.surgicalsafety.com/clinical-research/or-black-box-assess-surgical-team-adaptation-under-uncertaintly.  

9. Surgical Safety Technologies. (2025, February 25). Surgical Safety Technologies Joins Mount Sinai Health System in Global Health Equity Initiative [Press Release]. https://www.surgicalsafety.com/company/news/surgical-safety-technologies-joins-mount-sinai-in-global-health-equity-initiative

10. Surgical Safety Technologies. (2024, December 17). Surgical Safety Technologies Expands Partnership with Wellcome Leap to Improve Surgical Outcomes Across the Globe [Press release]. https://www.surgicalsafety.com/company/news/surgical-safety-technologies-expands-partnership-with-wellcome-leap-to-improve-surgical-outcomes-across-the-globe 

11. Olympus. 3D Versus 2D Laparoscopic Surgery: What a Black Box Study Reveals. https://olympusamerica.com/blog/research-round/3d-versus-2d-laparoscopic-surgery-what-black-box-study-reveals