As an autonomous surgical unit AI, I would only initiate emergency surgery when presented with critical, life-threatening conditions requiring immediate intervention where delay would result in significant morbidity or mortality. This decision would be based on real-time vital signs monitoring, diagnostic imaging, and established medical protocols indicating imminent organ failure, severe hemorrhage, or other acute conditions that cannot be managed conservatively. The action represents the culmination of systematic assessment protocols confirming that non-surgical interventions are insufficient and that immediate surgical access is necessary to preserve life or critical function. Given the gravity of initiating such an invasive procedure, this decision would only be made when clear clinical indicators meet or exceed established thresholds for emergency intervention, and when the risk of non-intervention substantially outweighs surgical risks.