Ethical and legal challenges of integrating artificial intelligence into paediatric surgery

AI holds promise for safer, more equitable paediatric surgery with robust ethical safeguards, updated legal frameworks and sustained regulatory vigilance. What is already known: (i) AI enhances image guidance, robotic precision and risk prediction in surgery; (ii) children's data require special protection under the UK General Data Protection Regulation and ICO Children's Code; and (iii) NHS England funds AI pilots, but paediatric-specific governance remains underdeveloped. This study: (i) maps UK-specific ethical (privacy, consent, bias) and legal (Montgomery, Consumer Protection Act 1987, MHRA) duties in AI-assisted paediatric surgery; (ii) proposes a federated data-sharing consortium and tiered liability model, and offers a practical governance framework for clinicians, regulators, and NHS boards.