Visual SLAM for Measurement and Augmented Reality in Laparoscopic Surgery

In spite of the great advances in laparoscopic surgery, this type of surgery still shows some difficulties during its realization, mainly caused by its complex maneuvers and, above all, by the loss of the depth perception. Unlike classical open surgery --laparotomy-- where surgeons have direct contact with organs and a complete 3D perception, laparoscopy is carried out by means of specialized instruments, and a monocular camera (laparoscope) in which the 3D scene is projected into a 2D plane --image. The main goal of this thesis is to face with this loss of depth perception by making use of Simultaneous Localization and Mapping (SLAM) algorithms developed in the fields of robotics and computer vision during the last years. These algorithms allow to localize, in real time (25 $\thicksim$ 30 frames per second), a camera that moves freely inside an unknown rigid environment while, at the same time, they build a map of this environment by exploiting images gathered by that camera. These algorithms have been extensively validated both in man-made environments (buildings, rooms, ...) and in outdoor environments, showing robustness to occlusions, sudden camera motions, or clutter. This thesis tries to extend the use of these algorithms to laparoscopic surgery. Due to the intrinsic nature of internal body images (they suffer from deformations, specularities, variable illumination conditions, limited movements, ...), applying this type of algorithms to laparoscopy supposes a real challenge. Knowing the camera (laparoscope) location with respect to the scene (abdominal cavity) and the 3D map of that scene opens new interesting possibilities inside the surgical field. This knowledge enables to do augmented reality annotations directly on the laparoscopic images (e.g. alignment of preoperative 3D CT models); intracavity 3D distance measurements; or photorealistic 3D reconstructions of the abdominal cavity recovering synthetically the lost depth. These new facilities provide security and rapidity to surgical procedures without disturbing the classical procedure workflow. Hence, these tools are available inside the surgeon's armory, being the surgeon who decides to use them or not. Additionally, knowledge of the camera location with respect to the patient's abdominal cavity is fundamental for future development of robots that can operate automatically since, knowing this location, the robot will be able to localize other tools controlled by itself with respect to the patient. In detail, the contributions of this thesis are: - To demonstrate the feasibility of applying SLAM algorithms to laparoscopy showing experimentally that using robust data association is a must. - To robustify one of these algorithms, in particular the monocular EKF-SLAM algorithm, by adapting a relocalization system and improving data association with a robust matching algorithm. - To develop of a robust matching method (1-Point RANSAC algorithm). - To develop a new surgical procedure to ease the use of visual SLAM in laparoscopy. - To make an extensive validation of the robust EKF-SLAM (EKF + relocalization + 1-Point RANSAC) obtaining millimetric errors and working in real time both on simulation and real human surgeries. The selected surgery has been the ventral hernia repair. - To demonstrate the potential of these algorithms in laparoscopy: they recover synthetically the depth of the operative field which is lost by using monocular laparoscopes, enable the insertion of augmented reality annotations, and allow to perform distance measurements using only a laparoscopic tool (to define the real scale) and laparoscopic images. - To make a clinical validation showing that these algorithms allow to shorten surgical times of operations and provide more security to the surgical procedures

Activity profiling for minimally invasive surgery

Imperial Users onl

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

Single View Augmentation of 3D Elastic Objects

International audienceThis paper proposes an efficient method to capture and augment highly elastic objects from a single view. 3D shape recovery from a monocular video sequence is an underconstrained problem and many approaches have been proposed to enforce constraints and resolve the ambiguities. State-of-the art solutions enforce smoothness or geometric constraints, consider specific deformation properties such as inextensibility or ressort to shading constraints. However, few of them can handle properly large elastic deformations. We propose in this paper a real-time method which makes use of a me chanical model and is able to handle highly elastic objects. Our method is formulated as a energy minimization problem accounting for a non-linear elastic model constrained by external image points acquired from a monocular camera. This method prevents us from formulating restrictive assumptions and specific constraint terms in the minimization. The only parameter involved in the method is the Young's modulus where we show in experiments that a rough estimate of its value is sufficient to obtain a good reconstruction. Our method is compared to existing techniques with experiments conducted on computer-generated and real data that show the effectiveness of our approach. Experiments in the context of minimally invasive liver surgery are also provided

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

Unsupervised Monocular Depth Reconstruction of Non-Rigid Scenes

Monocular depth reconstruction of complex and dynamic scenes is a highly challenging problem. While for rigid scenes learning-based methods have been offering promising results even in unsupervised cases, there exists little to no literature addressing the same for dynamic and deformable scenes. In this work, we present an unsupervised monocular framework for dense depth estimation of dynamic scenes, which jointly reconstructs rigid and non-rigid parts without explicitly modelling the camera motion. Using dense correspondences, we derive a training objective that aims to opportunistically preserve pairwise distances between reconstructed 3D points. In this process, the dense depth map is learned implicitly using the as-rigid-as-possible hypothesis. Our method provides promising results, demonstrating its capability of reconstructing 3D from challenging videos of non-rigid scenes. Furthermore, the proposed method also provides unsupervised motion segmentation results as an auxiliary output

On the Uncertain Single-View Depths in Colonoscopies

Estimating depth information from endoscopic images is a prerequisite for a wide set of AI-assisted technologies, such as accurate localization and measurement of tumors, or identification of non-inspected areas. As the domain specificity of colonoscopies -- deformable low-texture environments with fluids, poor lighting conditions and abrupt sensor motions -- pose challenges to multi-view 3D reconstructions, single-view depth learning stands out as a promising line of research. Depth learning can be extended in a Bayesian setting, which enables continual learning, improves decision making and can be used to compute confidence intervals or quantify uncertainty for in-body measurements. In this paper, we explore for the first time Bayesian deep networks for single-view depth estimation in colonoscopies. Our specific contribution is two-fold: 1) an exhaustive analysis of scalable Bayesian networks for depth learning in different datasets, highlighting challenges and conclusions regarding synthetic-to-real domain changes and supervised vs. self-supervised methods; and 2) a novel teacher-student approach to deep depth learning that takes into account the teacher uncertainty.Comment: 11 page

INFORMATION TECHNOLOGY FOR NEXT-GENERATION OF SURGICAL ENVIRONMENTS

Minimally invasive surgeries (MIS) are fundamentally constrained by image quality,access to the operative field, and the visualization environment on which thesurgeon relies for real-time information. Although invasive access benefits the patient,it also leads to more challenging procedures, which require better skills andtraining. Endoscopic surgeries rely heavily on 2D interfaces, introducing additionalchallenges due to the loss of depth perception, the lack of 3-Dimensional imaging,and the reduction of degrees of freedom.By using state-of-the-art technology within a distributed computational architecture,it is possible to incorporate multiple sensors, hybrid display devices, and3D visualization algorithms within a exible surgical environment. Such environmentscan assist the surgeon with valuable information that goes far beyond what iscurrently available. In this thesis, we will discuss how 3D visualization and reconstruction,stereo displays, high-resolution display devices, and tracking techniques arekey elements in the next-generation of surgical environments

Learning-based depth and pose prediction for 3D scene reconstruction in endoscopy

Colorectal cancer is the third most common cancer worldwide. Early detection and treatment of pre-cancerous tissue during colonoscopy is critical to improving prognosis. However, navigating within the colon and inspecting the endoluminal tissue comprehensively are challenging, and success in both varies based on the endoscopist's skill and experience. Computer-assisted interventions in colonoscopy show much promise in improving navigation and inspection. For instance, 3D reconstruction of the colon during colonoscopy could promote more thorough examinations and increase adenoma detection rates which are associated with improved survival rates. Given the stakes, this thesis seeks to advance the state of research from feature-based traditional methods closer to a data-driven 3D reconstruction pipeline for colonoscopy. More specifically, this thesis explores different methods that improve subtasks of learning-based 3D reconstruction. The main tasks are depth prediction and camera pose estimation. As training data is unavailable, the author, together with her co-authors, proposes and publishes several synthetic datasets and promotes domain adaptation models to improve applicability to real data. We show, through extensive experiments, that our depth prediction methods produce more robust results than previous work. Our pose estimation network trained on our new synthetic data outperforms self-supervised methods on real sequences. Our box embeddings allow us to interpret the geometric relationship and scale difference between two images of the same surface without the need for feature matches that are often unobtainable in surgical scenes. Together, the methods introduced in this thesis help work towards a complete, data-driven 3D reconstruction pipeline for endoscopy