Activity profiling for minimally invasive surgery

Imperial Users onl

Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

Appearance Modelling and Reconstruction for Navigation in Minimally Invasive Surgery

Minimally invasive surgery is playing an increasingly important role for patient care. Whilst its direct patient benefit in terms of reduced trauma, improved recovery and shortened hospitalisation has been well established, there is a sustained need for improved training of the existing procedures and the development of new smart instruments to tackle the issue of visualisation, ergonomic control, haptic and tactile feedback. For endoscopic intervention, the small field of view in the presence of a complex anatomy can easily introduce disorientation to the operator as the tortuous access pathway is not always easy to predict and control with standard endoscopes. Effective training through simulation devices, based on either virtual reality or mixed-reality simulators, can help to improve the spatial awareness, consistency and safety of these procedures. This thesis examines the use of endoscopic videos for both simulation and navigation purposes. More specifically, it addresses the challenging problem of how to build high-fidelity subject-specific simulation environments for improved training and skills assessment. Issues related to mesh parameterisation and texture blending are investigated. With the maturity of computer vision in terms of both 3D shape reconstruction and localisation and mapping, vision-based techniques have enjoyed significant interest in recent years for surgical navigation. The thesis also tackles the problem of how to use vision-based techniques for providing a detailed 3D map and dynamically expanded field of view to improve spatial awareness and avoid operator disorientation. The key advantage of this approach is that it does not require additional hardware, and thus introduces minimal interference to the existing surgical workflow. The derived 3D map can be effectively integrated with pre-operative data, allowing both global and local 3D navigation by taking into account tissue structural and appearance changes. Both simulation and laboratory-based experiments are conducted throughout this research to assess the practical value of the method proposed

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

Laparoscopic Image Recovery and Stereo Matching

Laparoscopic imaging can play a significant role in the minimally invasive surgical procedure. However, laparoscopic images often suffer from insufficient and irregular light sources, specular highlight surfaces, and a lack of depth information. These problems can negatively influence the surgeons during surgery, and lead to erroneous visual tracking and potential surgical risks. Thus, developing effective image-processing algorithms for laparoscopic vision recovery and stereo matching is of significant importance. Most related algorithms are effective on nature images, but less effective on laparoscopic images. The first purpose of this thesis is to restore low-light laparoscopic vision, where an effective image enhancement method is proposed by identifying different illumination regions and designing the enhancement criteria for desired image quality. This method can enhance the low-light region by reducing noise amplification during the enhancement process. In addition, this thesis also proposes a simplified Retinex optimization method for non-uniform illumination enhancement. By integrating the prior information of the illumination and reflectance into the optimization process, this method can significantly enhance the dark region while preserving naturalness, texture details, and image structures. Moreover, due to the replacement of the total variation term with two $l_2$-norm terms, the proposed algorithm has a significant computational advantage. Second, a global optimization method for specular highlight removal from a single laparoscopic image is proposed. This method consists of a modified dichromatic reflection model and a novel diffuse chromaticity estimation technique. Due to utilizing the limited color variation of the laparoscopic image, the estimated diffuse chromaticity can approximate the true diffuse chromaticity, which allows us to effectively remove the specular highlight with texture detail preservation. Third, a robust edge-preserving stereo matching method is proposed, based on sparse feature matching, left and right illumination equalization, and refined disparity optimization processes. The sparse feature matching and illumination equalization techniques can provide a good disparity map initialization so that our refined disparity optimization can quickly obtain an accurate disparity map. This approach is particularly promising on surgical tool edges, smooth soft tissues, and surfaces with strong specular highlight

Specular reflection removal and bloodless vessel segmentation for 3-D heart model reconstruction from single view images

Three Dimensional (3D) human heart model is attracting attention for its role in medical images for education and clinical purposes. Analysing 2D images to obtain meaningful information requires a certain level of expertise. Moreover, it is time consuming and requires special devices to obtain aforementioned images. In contrary, a 3D model conveys much more information. 3D human heart model reconstruction from medical imaging devices requires several input images, while reconstruction from a single view image is challenging due to the colour property of the heart image, light reflections, and its featureless surface. Lights and illumination condition of the operating room cause specular reflections on the wet heart surface that result in noises forming of the reconstruction process. Image-based technique is used for the proposed human heart surface reconstruction. It is important the reflection is eliminated to allow for proper 3D reconstruction and avoid imperfect final output. Specular reflections detection and correction process examine the surface properties. This was implemented as a first step to detect reflections using the standard deviation of RGB colour channel and the maximum value of blue channel to establish colour, devoid of specularities. The result shows the accurate and efficient performance of the specularities removing process with 88.7% similarity with the ground truth. Realistic 3D heart model reconstruction was developed based on extraction of pixel information from digital images to allow novice surgeons to reduce the time for cardiac surgery training and enhancing their perception of the Operating Theatre (OT). Cardiac medical imaging devices such as Magnetic Resonance Imaging (MRI), Computed Tomography (CT) images, or Echocardiography provide cardiac information. However,these images from medical modalities are not adequate, to precisely simulate the real environment and to be used in the training simulator for cardiac surgery. The propose method exploits and develops techniques based on analysing real coloured images taken during cardiac surgery in order to obtain meaningful information of the heart anatomical structures. Another issue is the different human heart surface vessels. The most important vessel region is the bloodless, lack of blood, vessels. Surgeon faces some difficulties in locating the bloodless vessel region during surgery. The thesis suggests a technique of identifying the vessels’ Region of Interest (ROI) to avoid surgical injuries by examining an enhanced input image. The proposed method locates vessels’ ROI by using Decorrelation Stretch technique. This Decorrelation Stretch can clearly enhance the heart’s surface image. Through this enhancement, the surgeon become enables effectively identifying the vessels ROI to perform the surgery from textured and coloured surface images. In addition, after enhancement and segmentation of the vessels ROI, a 3D reconstruction of this ROI takes place and then visualize it over the 3D heart model. Experiments for each phase in the research framework were qualitatively and quantitatively evaluated. Two hundred and thirteen real human heart images are the dataset collected during cardiac surgery using a digital camera. The experimental results of the proposed methods were compared with manual hand-labelling ground truth data. The cost reduction of false positive and false negative of specular detection and correction processes of the proposed method was less than 24% compared to other methods. In addition, the efficient results of Root Mean Square Error (RMSE) to measure the correctness of the z-axis values to reconstruction of the 3D model accurately compared to other method. Finally, the 94.42% accuracy rate of the proposed vessels segmentation method using RGB colour space achieved is comparable to other colour spaces. Experimental results show that there is significant efficiency and robustness compared to existing state of the art methods

Multisensory Imagery Cues for Object Separation, Specularity Detection and Deep Learning based Inpainting

Multisensory imagery cues have been actively investigated in diverse applications in the computer vision community to provide additional geometric information that is either absent or difficult to capture from mainstream two-dimensional imaging. The inherent features of multispectral polarimetric light field imagery (MSPLFI) include object distribution over spectra, surface properties, shape, shading and pixel flow in light space. The aim of this dissertation is to explore these inherent properties to exploit new structures and methodologies for the tasks of object separation, specularity detection and deep learning-based inpainting in MSPLFI. In the first part of this research, an application to separate foreground objects from the background in both outdoor and indoor scenes using multispectral polarimetric imagery (MSPI) cues is examined. Based on the pixel neighbourhood relationship, an on-demand clustering technique is proposed and implemented to separate artificial objects from natural background in a complex outdoor scene. However, due to indoor scenes only containing artificial objects, with vast variations in energy levels among spectra, a multiband fusion technique followed by a background segmentation algorithm is proposed to separate the foreground from the background. In this regard, first, each spectrum is decomposed into low and high frequencies using the fast Fourier transform (FFT) method. Second, principal component analysis (PCA) is applied on both frequency images of the individual spectrum and then combined with the first principal components as a fused image. Finally, a polarimetric background segmentation (BS) algorithm based on the Stokes vector is proposed and implemented on the fused image. The performance of the proposed approaches are evaluated and compared using publicly available MSPI datasets and the dice similarity coefficient (DSC). The proposed multiband fusion and BS methods demonstrate better fusion quality and higher segmentation accuracy compared with other studies for several metrics, including mean absolute percentage error (MAPE), peak signal-to-noise ratio (PSNR), Pearson correlation coefficient (PCOR) mutual information (MI), accuracy, Geometric Mean (G-mean), precision, recall and F1-score. In the second part of this work, a twofold framework for specular reflection detection (SRD) and specular reflection inpainting (SRI) in transparent objects is proposed. The SRD algorithm is based on the mean, the covariance and the Mahalanobis distance for predicting anomalous pixels in MSPLFI. The SRI algorithm first selects four-connected neighbouring pixels from sub-aperture images and then replaces the SRD pixel with the closest matched pixel. For both algorithms, a 6D MSPLFI transparent object dataset is captured from multisensory imagery cues due to the unavailability of this kind of dataset. The experimental results demonstrate that the proposed algorithms predict higher SRD accuracy and better SRI quality than the existing approaches reported in this part in terms of F1-score, G-mean, accuracy, the structural similarity index (SSIM), the PSNR, the mean squared error (IMMSE) and the mean absolute deviation (MAD). However, due to synthesising SRD pixels based on the pixel neighbourhood relationship, the proposed inpainting method in this research produces artefacts and errors when inpainting large specularity areas with irregular holes. Therefore, in the last part of this research, the emphasis is on inpainting large specularity areas with irregular holes based on the deep feature extraction from multisensory imagery cues. The proposed six-stage deep learning inpainting (DLI) framework is based on the generative adversarial network (GAN) architecture and consists of a generator network and a discriminator network. First, pixels’ global flow in the sub-aperture images is calculated by applying the large displacement optical flow (LDOF) method. The proposed training algorithm combines global flow with local flow and coarse inpainting results predicted from the baseline method. The generator attempts to generate best-matched features, while the discriminator seeks to predict the maximum difference between the predicted results and the actual results. The experimental results demonstrate that in terms of the PSNR, MSSIM, IMMSE and MAD, the proposed DLI framework predicts superior inpainting quality to the baseline method and the previous part of this research

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