Recent advancements in technology, particularly in machine learning (ML), deep learning (DL), and the metaverse, offer great potential for revolutionizing surgical science. The combination of artificial intelligence and extended reality (AI-XR) technologies has the potential to create a surgical metaverse, a virtual environment where surgeries can be planned and performed. This paper aims to provide insight into the various potential applications of an AI-XR surgical metaverse and the challenges that must be addressed to bring its full potential to fruition. It is important for the community to focus on these challenges to fully realize the potential of the AI-XR surgical metaverses. Furthermore, to emphasize the need for secure and robust AI-XR surgical metaverses and to demonstrate the real-world implications of security threats to the AI-XR surgical metaverses, we present a case study in which the ``an immersive surgical attack'' on incision point localization is performed in the context of preoperative planning in a surgical metaverse.