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Abstract

Introduction: Artificial intelligence (AI) is increasingly integrated into healthcare, including surgery, with applications spanning the patient journey. Despite interest, there is no consensus on the role, scope, or integration of surgeon-facing AI assistants, termed here as “AI Co-Pilots.” The perspectives of surgeons, including consultants and trainees, have not been systematically explored. This study seeks to develop an international consensus on the functions, usability, and implementation of an AI Co-Pilot in surgery from the perspectives of both consultants and trainees. Methods: A two-panel modified e-Delphi study will involve approximately 50 consultant surgeons and 50 surgical trainees internationally, representing multiple countries, regions and specialties, including those with and without AI familiarity. A preparatory phase will establish a steering group, review evidence, and define survey items. Up to three iterative rounds will rate statements on a nine-point Likert scale, with aggregated group feedback, aiming for ≥80% agreement (scores 7-9). Final analysis will synthesise consensus, near-consensus, and disagreement into recommendations. Qualitative data will be thematically analysed. Expected Outcomes: The study will produce consensus-based guidelines for AI Co-Pilot design and implementation in surgical practice, tailored to career stage. Findings will inform procurement, training, regulation, and future validation efforts.