Father-of-two has tumour removed in pioneering operation guided by live artificial intelligence

The world’s first brain surgery performed with live artificial intelligence assistance has been successfully completed in London, with a father-of-two from Bedfordshire having a tumour removed that could otherwise have cost him his sight. Rhys Hibbert, 48, underwent the pioneering procedure at University College London Hospital, where a bespoke AI tool analysed a video feed of the operation as it unfolded, advising surgeons on how to avoid crucial but hidden blood vessels and nerves.

Until 18 months ago, Hibbert, a customer services manager, was fit and healthy, walking two miles every lunchtime. It was on one of these walks that he collapsed unconscious and began fitting in the road. A brain scan revealed an 11mm non-cancerous tumour growing on his pituitary gland, a marble-sized organ at the base of the skull that secretes hormones regulating growth, metabolism, blood pressure and temperature. Crucially, the gland sits close to the carotid arteries, which supply blood to the brain, and the optic nerves that control vision. As the tumour pressed on those nerves, Hibbert’s peripheral vision narrowed. Severely fatigued and dizzy, he began tripping over things.

Although surgery was not immediately required, the psychological toll was significant. “For 18 years of married life I’ve always got out of bed and made my wife a cup of coffee,” Hibbert said, “and I wasn’t going to let this tumour stop that.” He added that while many people offered help, “you don’t want to be a burden on people.”

Surgeons presented Hibbert with the option of becoming the first patient to undergo the operation with their AI tool. He accepted without hesitation, reasoning that without patients willing to join research, doctors could never learn and medicine could never progress. The procedure involved inserting an endoscope through the nose to the base of the skull, where the tumour lay hidden behind bone and tough membrane. Identifying the safest extraction point was complicated by the fact that anatomy varies between individuals. Complication rates are significant: a 25 to 50 per cent chance of incomplete removal and a 0.5 to 2 per cent risk of injuring a major blood vessel.

This is where the AI tool proved invaluable. Displayed on a second screen, it analysed the live video feed, tracked surgical instruments, and highlighted areas where vessels and nerves were most likely to be, marking the safest zones for tumour removal. The system, trained on hundreds of videos of pituitary tumour removals, had been taught by surgeons carefully drawing around anatomical structures in each video. “It is trained on more operations than most surgeons see or do in a lifetime and can act like an expert second pair of eyes,” said Prof Hani Marcus, who helped carry out the procedure. Unlike other experimental AI tools, this one works in real time, he added.

The team, funded by the National Institute for Health and Care Research and Google, spent years testing the technology in the lab. Their long-term ambition is to develop a type of ChatGPT for surgeons—an expert adviser in the room that they can consult or disregard as they see fit. Prof Marcus stressed that surgeons retain full control. “From a patient safety perspective, I can see absolutely the benefit,” Hibbert said. “There are no road signs inside our head.”

Eight weeks after the operation, Hibbert reports that his vision has been improving every few days. “When I opened my eyes after the operation it felt like I had got 360-degree vision—I hadn’t seen that clearly for a year,” he said. “I also have my energy back and all of the side effects I was suffering before surgery have gone. It’s given me my life back.” James Frith, the health innovation minister, welcomed the “life-changing surgery” as part of government-funded research, adding that while AI requires proper safeguards, the opportunities it brings must also be embraced.