Comparative validation of single-shot optical techniques for laparoscopic 3-D surface reconstruction

Intra-operative imaging techniques for obtaining the shape and morphology of soft-tissue surfaces in vivo are a key enabling technology for advanced surgical systems. Different optical techniques for 3-D surface reconstruction in laparoscopy have been proposed, however, so far no quantitative and comparative validation has been performed. Furthermore, robustness of the methods to clinically important factors like smoke or bleeding has not yet been assessed. To address these issues, we have formed a joint international initiative with the aim of validating different state-of-the-art passive and active reconstruction methods in a comparative manner. In this comprehensive in vitro study, we investigated reconstruction accuracy using different organs with various shape and texture and also tested reconstruction robustness with respect to a number of factors like the pose of the endoscope as well as the amount of blood or smoke present in the scene. The study suggests complementary advantages of the different techniques with respect to accuracy, robustness, point density, hardware complexity and computation time. While reconstruction accuracy under ideal conditions was generally high, robustness is a remaining issue to be addressed. Future work should include sensor fusion and in vivo validation studies in a specific clinical context. To trigger further research in surface reconstruction, stereoscopic data of the study will be made publically available at www.open-CAS.com upon publication of the paper

Probe-based Rapid Hybrid Hyperspectral and Tissue Surface Imaging Aided by Fully Convolutional Networks

Tissue surface shape and reflectance spectra provide rich intra-operative information useful in surgical guidance. We propose a hybrid system which displays an endoscopic image with a fast joint inspection of tissue surface shape using structured light (SL) and hyperspectral imaging (HSI). For SL a miniature fibre probe is used to project a coloured spot pattern onto the tissue surface. In HSI mode standard endoscopic illumination is used, with the fibre probe collecting reflected light and encoding the spatial information into a linear format that can be imaged onto the slit of a spectrograph. Correspondence between the arrangement of fibres at the distal and proximal ends of the bundle was found using spectral encoding. Then during pattern decoding, a fully convolutional network (FCN) was used for spot detection, followed by a matching propagation algorithm for spot identification. This method enabled fast reconstruction (12 frames per second) using a GPU. The hyperspectral image was combined with the white light image and the reconstructed surface, showing the spectral information of different areas. Validation of this system using phantom and ex vivo experiments has been demonstrated.Comment: This paper has been submitted to MICCAI2016 on 17 March, 2016, and conditionally accepted on 2 June, 201

Impact of Soft Tissue Heterogeneity on Augmented Reality for Liver Surgery

International audienceThis paper presents a method for real-time augmented reality of internal liver structures during minimally invasive hepatic surgery. Vessels and tumors computed from pre-operative CT scans can be overlaid onto the laparoscopic view for surgery guidance. Compared to current methods, our method is able to locate the in-depth positions of the tumors based on partial three-dimensional liver tissue motion using a real-time biomechanical model. This model permits to properly handle the motion of internal structures even in the case of anisotropic or heterogeneous tissues, as it is the case for the liver and many anatomical structures. Experimentations conducted on phantom liver permits to measure the accuracy of the augmentation while real-time augmentation on in vivo human liver during real surgery shows the benefits of such an approach for minimally invasive surgery

Development of a surgical stereo endoscopic image dataset for validating 3D stereo reconstruction algorithms

In the last decades, endoscopic stereo images have been exploited to retrieve tissue surface information of the surgical site using 3D reconstruction algorithms. The application of such algorithms in Computer Assisted Surgery (CAS) tools for Minimally Invasive Surgery (MIS) requires a robust validation process in order to guarantee reliability and safety. 3D reconstruction algorithms are commonly evaluated comparing their result with respect to a reference Ground Truth (GT). However, few datasets providing endoscopic images and GT are openly available. Considering the increasing necessity of surgical datasets, the aim of this work is the generation of an Endoscopic Abdominal Stereo (EndoAbS) dataset composed of stereo-images with associated GT for 3D stereo-reconstruction algorithm validation. To recreate the surgical scenario, a polyurethane surgical phantom abdomen was built. Images were captured with a stereo-endoscope, while for acquiring the GT a laser scanner (calibrated with respect to the stereoendoscope) was used. This dataset is openly available on-line for the benefit of the CAS community

Performance of image guided navigation in laparoscopic liver surgery – A systematic review

Background: Compared to open surgery, minimally invasive liver resection has improved short term outcomes. It is however technically more challenging. Navigated image guidance systems (IGS) are being developed to overcome these challenges. The aim of this systematic review is to provide an overview of their current capabilities and limitations. Methods: Medline, Embase and Cochrane databases were searched using free text terms and corresponding controlled vocabulary. Titles and abstracts of retrieved articles were screened for inclusion criteria. Due to the heterogeneity of the retrieved data it was not possible to conduct a meta-analysis. Therefore results are presented in tabulated and narrative format. Results: Out of 2015 articles, 17 pre-clinical and 33 clinical papers met inclusion criteria. Data from 24 articles that reported on accuracy indicates that in recent years navigation accuracy has been in the range of 8–15 mm. Due to discrepancies in evaluation methods it is difficult to compare accuracy metrics between different systems. Surgeon feedback suggests that current state of the art IGS may be useful as a supplementary navigation tool, especially in small liver lesions that are difficult to locate. They are however not able to reliably localise all relevant anatomical structures. Only one article investigated IGS impact on clinical outcomes. Conclusions: Further improvements in navigation accuracy are needed to enable reliable visualisation of tumour margins with the precision required for oncological resections. To enhance comparability between different IGS it is crucial to find a consensus on the assessment of navigation accuracy as a minimum reporting standard

EnViSoRS: Enhanced Vision System for Robotic Surgery. A User-Defined Safety Volume Tracking to Minimize the Risk of Intraoperative Bleeding

open6siIn abdominal surgery, intra-operative bleeding is one of the major complications that affect the outcome of minimally invasive surgical procedures. One of the causes is attributed to accidental damages to arteries or veins, and one of the possible risk factors falls on the surgeon's skills. This paper presents the development and application of an Enhanced Vision System for Robotic Surgery (EnViSoRS), based on a user-defined Safety Volume (SV) tracking to minimise the risk of intra-operative bleeding. It aims at enhancing the surgeon's capabilities by providing Augmented Reality (AR) assistance towards the protection of vessels from injury during the execution of surgical procedures with a robot. The core of the framework consists in: (i) a hybrid tracking algorithm (LT-SAT tracker) that robustly follows a user-defined Safety Area (SA) in long term; (ii) a dense soft tissue 3D reconstruction algorithm, necessary for the computation of the SV; (iii) AR features for visualisation of the SV to be protected and of a graphical gauge indicating the current distance between the instruments and the reconstructed surface. EnViSoRS was integrated with a commercial robotic surgery system (the dVRK system) for testing and validation. The experiments aimed at demonstrating the accuracy, robustness, performance and usability of EnViSoRS during the execution of a simulated surgical task on a liver phantom. Results show an overall accuracy in accordance with surgical requirements (< 5mm), and high robustness in the computation of the SV in terms of precision and recall of its identification. The optimisation strategy implemented to speed up the computational time is also described and evaluated, providing AR features update rate up to 4 fps without impacting the real-time visualisation of the stereo endoscopic video. Finally, qualitative results regarding the system usability indicate that the proposed system integrates well with the commercial surgical robot and has indeed potential to offer useful assistance during real surgeries.openPenza, Veronica; De Momi, Elena; Enayati, Nima; Chupin, Thibaud; Ortiz, Jesús; Mattos, Leonardo S.Penza, Veronica; DE MOMI, Elena; Enayati, Nima; Chupin, THIBAUD JEAN EUDES; Ortiz, Jesús; Mattos, Leonardo S

A comprehensive survey on recent deep learning-based methods applied to surgical data

Minimally invasive surgery is highly operator dependant with a lengthy procedural time causing fatigue to surgeon and risks to patients such as injury to organs, infection, bleeding, and complications of anesthesia. To mitigate such risks, real-time systems are desired to be developed that can provide intra-operative guidance to surgeons. For example, an automated system for tool localization, tool (or tissue) tracking, and depth estimation can enable a clear understanding of surgical scenes preventing miscalculations during surgical procedures. In this work, we present a systematic review of recent machine learning-based approaches including surgical tool localization, segmentation, tracking, and 3D scene perception. Furthermore, we provide a detailed overview of publicly available benchmark datasets widely used for surgical navigation tasks. While recent deep learning architectures have shown promising results, there are still several open research problems such as a lack of annotated datasets, the presence of artifacts in surgical scenes, and non-textured surfaces that hinder 3D reconstruction of the anatomical structures. Based on our comprehensive review, we present a discussion on current gaps and needed steps to improve the adaptation of technology in surgery.Comment: This paper is to be submitted to International journal of computer visio

Dense Vision in Image-guided Surgery

Image-guided surgery needs an efficient and effective camera tracking system in order to perform augmented reality for overlaying preoperative models or label cancerous tissues on the 2D video images of the surgical scene. Tracking in endoscopic/laparoscopic scenes however is an extremely difficult task primarily due to tissue deformation, instrument invasion into the surgical scene and the presence of specular highlights. State of the art feature-based SLAM systems such as PTAM fail in tracking such scenes since the number of good features to track is very limited. When the scene is smoky and when there are instrument motions, it will cause feature-based tracking to fail immediately. The work of this thesis provides a systematic approach to this problem using dense vision. We initially attempted to register a 3D preoperative model with multiple 2D endoscopic/laparoscopic images using a dense method but this approach did not perform well. We subsequently proposed stereo reconstruction to directly obtain the 3D structure of the scene. By using the dense reconstructed model together with robust estimation, we demonstrate that dense stereo tracking can be incredibly robust even within extremely challenging endoscopic/laparoscopic scenes. Several validation experiments have been conducted in this thesis. The proposed stereo reconstruction algorithm has turned out to be the state of the art method for several publicly available ground truth datasets. Furthermore, the proposed robust dense stereo tracking algorithm has been proved highly accurate in synthetic environment (< 0.1 mm RMSE) and qualitatively extremely robust when being applied to real scenes in RALP prostatectomy surgery. This is an important step toward achieving accurate image-guided laparoscopic surgery.Open Acces

Tissue classification for laparoscopic image understanding based on multispectral texture analysis.

Intraoperative tissue classification is one of the prerequisites for providing context-aware visualization in computer-assisted minimally invasive surgeries. As many anatomical structures are difficult to differentiate in conventional RGB medical images, we propose a classification method based on multispectral image patches. In a comprehensive ex vivo study through statistical analysis, we show that (1) multispectral imaging data are superior to RGB data for organ tissue classification when used in conjunction with widely applied feature descriptors and (2) combining the tissue texture with the reflectance spectrum improves the classification performance. The classifier reaches an accuracy of 98.4% on our dataset. Multispectral tissue analysis could thus evolve as a key enabling technique in computer-assisted laparoscopy

SERV-CT: A disparity dataset from cone-beam CT for validation of endoscopic 3D reconstruction

In computer vision, reference datasets from simulation and real outdoor scenes have been highly successful in promoting algorithmic development in stereo reconstruction. Endoscopic stereo reconstruction for surgical scenes gives rise to specific problems, including the lack of clear corner features, highly specular surface properties and the presence of blood and smoke. These issues present difficulties for both stereo reconstruction itself and also for standardised dataset production. Previous datasets have been produced using computed tomography (CT) or structured light reconstruction on phantom or ex vivo models. We present a stereo-endoscopic reconstruction validation dataset based on cone-beam CT (SERV-CT). Two ex vivo small porcine full torso cadavers were placed within the view of the endoscope with both the endoscope and target anatomy visible in the CT scan. Subsequent orientation of the endoscope was manually aligned to match the stereoscopic view and benchmark disparities, depths and occlusions are calculated. The requirement of a CT scan limited the number of stereo pairs to 8 from each ex vivo sample. For the second sample an RGB surface was acquired to aid alignment of smooth, featureless surfaces. Repeated manual alignments showed an RMS disparity accuracy of around 2 pixels and a depth accuracy of about 2 mm. A simplified reference dataset is provided consisting of endoscope image pairs with corresponding calibration, disparities, depths and occlusions covering the majority of the endoscopic image and a range of tissue types, including smooth specular surfaces, as well as significant variation of depth. We assessed the performance of various stereo algorithms from online available repositories. There is a significant variation between algorithms, highlighting some of the challenges of surgical endoscopic images. The SERV-CT dataset provides an easy to use stereoscopic validation for surgical applications with smooth reference disparities and depths covering the majority of the endoscopic image. This complements existing resources well and we hope will aid the development of surgical endoscopic anatomical reconstruction algorithms