Temporal Segmentation of Surgical Sub-tasks through Deep Learning with Multiple Data Sources

Many tasks in robot-assisted surgeries (RAS) can be represented by finite-state machines (FSMs), where each state represents either an action (such as picking up a needle) or an observation (such as bleeding). A crucial step towards the automation of such surgical tasks is the temporal perception of the current surgical scene, which requires a real-time estimation of the states in the FSMs. The objective of this work is to estimate the current state of the surgical task based on the actions performed or events occurred as the task progresses. We propose Fusion-KVE, a unified surgical state estimation model that incorporates multiple data sources including the Kinematics, Vision, and system Events. Additionally, we examine the strengths and weaknesses of different state estimation models in segmenting states with different representative features or levels of granularity. We evaluate our model on the JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS), as well as a more complex dataset involving robotic intra-operative ultrasound (RIOUS) imaging, created using the da Vinci® Xi surgical system. Our model achieves a superior frame-wise state estimation accuracy up to 89.4%, which improves the state-of-the-art surgical state estimation models in both JIGSAWS suturing dataset and our RIOUS dataset

Temporal Segmentation of Surgical Sub-tasks through Deep Learning with Multiple Data Sources

Many tasks in robot-assisted surgeries (RAS) can be represented by finite-state machines (FSMs), where each state represents either an action (such as picking up a needle) or an observation (such as bleeding). A crucial step towards the automation of such surgical tasks is the temporal perception of the current surgical scene, which requires a real-time estimation of the states in the FSMs. The objective of this work is to estimate the current state of the surgical task based on the actions performed or events occurred as the task progresses. We propose Fusion-KVE, a unified surgical state estimation model that incorporates multiple data sources including the Kinematics, Vision, and system Events. Additionally, we examine the strengths and weaknesses of different state estimation models in segmenting states with different representative features or levels of granularity. We evaluate our model on the JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS), as well as a more complex dataset involving robotic intra-operative ultrasound (RIOUS) imaging, created using the da Vinci® Xi surgical system. Our model achieves a superior frame-wise state estimation accuracy up to 89.4%, which improves the state-of-the-art surgical state estimation models in both JIGSAWS suturing dataset and our RIOUS dataset

Gesture Recognition in Robotic Surgery: a Review

OBJECTIVE: Surgical activity recognition is a fundamental step in computer-assisted interventions. This paper reviews the state-of-the-art in methods for automatic recognition of fine-grained gestures in robotic surgery focusing on recent data-driven approaches and outlines the open questions and future research directions. METHODS: An article search was performed on 5 bibliographic databases with combinations of the following search terms: robotic, robot-assisted, JIGSAWS, surgery, surgical, gesture, fine-grained, surgeme, action, trajectory, segmentation, recognition, parsing. Selected articles were classified based on the level of supervision required for training and divided into different groups representing major frameworks for time series analysis and data modelling. RESULTS: A total of 52 articles were reviewed. The research field is showing rapid expansion, with the majority of articles published in the last 4 years. Deep-learning-based temporal models with discriminative feature extraction and multi-modal data integration have demonstrated promising results on small surgical datasets. Currently, unsupervised methods perform significantly less well than the supervised approaches. CONCLUSION: The development of large and diverse open-source datasets of annotated demonstrations is essential for development and validation of robust solutions for surgical gesture recognition. While new strategies for discriminative feature extraction and knowledge transfer, or unsupervised and semi-supervised approaches, can mitigate the need for data and labels, they have not yet been demonstrated to achieve comparable performance. Important future research directions include detection and forecast of gesture-specific errors and anomalies. SIGNIFICANCE: This paper is a comprehensive and structured analysis of surgical gesture recognition methods aiming to summarize the status of this rapidly evolving field

Who's Better? Who's Best? Pairwise Deep Ranking for Skill Determination

We present a method for assessing skill from video, applicable to a variety of tasks, ranging from surgery to drawing and rolling pizza dough. We formulate the problem as pairwise (who's better?) and overall (who's best?) ranking of video collections, using supervised deep ranking. We propose a novel loss function that learns discriminative features when a pair of videos exhibit variance in skill, and learns shared features when a pair of videos exhibit comparable skill levels. Results demonstrate our method is applicable across tasks, with the percentage of correctly ordered pairs of videos ranging from 70% to 83% for four datasets. We demonstrate the robustness of our approach via sensitivity analysis of its parameters. We see this work as effort toward the automated organization of how-to video collections and overall, generic skill determination in video.Comment: CVPR 201

Gesture Recognition in Robotic Surgery with Multimodal Attention

Automatically recognising surgical gestures from surgical data is an important building block of automated activity recognition and analytics, technical skill assessment, intra-operative assistance and eventually robotic automation. The complexity of articulated instrument trajectories and the inherent variability due to surgical style and patient anatomy make analysis and fine-grained segmentation of surgical motion patterns from robot kinematics alone very difficult. Surgical video provides crucial information from the surgical site with context for the kinematic data and the interaction between the instruments and tissue. Yet sensor fusion between the robot data and surgical video stream is non-trivial because the data have different frequency, dimensions and discriminative capability. In this paper, we integrate multimodal attention mechanisms in a two-stream temporal convolutional network to compute relevance scores and weight kinematic and visual feature representations dynamically in time, aiming to aid multimodal network training and achieve effective sensor fusion. We report the results of our system on the JIGSAWS benchmark dataset and on a new in vivo dataset of suturing segments from robotic prostatectomy procedures. Our results are promising and obtain multimodal prediction sequences with higher accuracy and better temporal structure than corresponding unimodal solutions. Visualization of attention scores also gives physically interpretable insights on network understanding of strengths and weaknesses of each sensor

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

daVinciNet: Joint Prediction of Motion and Surgical State in Robot-Assisted Surgery

This paper presents a technique to concurrently and jointly predict the future trajectories of surgical instruments and the future state(s) of surgical subtasks in robot-assisted surgeries (RAS) using multiple input sources. Such predictions are a necessary first step towards shared control and supervised autonomy of surgical subtasks. Minute-long surgical subtasks, such as suturing or ultrasound scanning, often have distinguishable tool kinematics and visual features, and can be described as a series of fine-grained states with transition schematics. We propose daVinciNet - an end-to-end dual-task model for robot motion and surgical state predictions. daVinciNet performs concurrent end-effector trajectory and surgical state predictions using features extracted from multiple data streams, including robot kinematics, endoscopic vision, and system events. We evaluate our proposed model on an extended Robotic Intra-Operative Ultrasound (RIOUS+) imaging dataset collected on a da Vinci Xi surgical system and the JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS). Our model achieves up to 93.85% short-term (0.5s) and 82.11% long-term (2s) state prediction accuracy, as well as 1.07mm short-term and 5.62mm long-term trajectory prediction error.Comment: Accepted to IROS 202

daVinciNet: Joint Prediction of Motion and Surgical State in Robot-Assisted Surgery

This paper presents a technique to concurrently and jointly predict the future trajectories of surgical instruments and the future state(s) of surgical subtasks in robot-assisted surgeries (RAS) using multiple input sources. Such predictions are a necessary first step towards shared control and supervised autonomy of surgical subtasks. Minute-long surgical subtasks, such as suturing or ultrasound scanning, often have distinguishable tool kinematics and visual features, and can be described as a series of fine-grained states with transition schematics. We propose daVinciNet - an end-to-end dual-task model for robot motion and surgical state predictions. daVinciNet performs concurrent end-effector trajectory and surgical state predictions using features extracted from multiple data streams, including robot kinematics, endoscopic vision, and system events. We evaluate our proposed model on an extended Robotic Intra-Operative Ultrasound (RIOUS+) imaging dataset collected on a da Vinci Xi surgical system and the JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS). Our model achieves up to 93.85% short-term (0.5s) and 82.11% long-term (2s) state prediction accuracy, as well as 1.07mm short-term and 5.62mm long-term trajectory prediction error