TeCNO: Surgical Phase Recognition with Multi-Stage Temporal Convolutional Networks

Automatic surgical phase recognition is a challenging and crucial task with the potential to improve patient safety and become an integral part of intra-operative decision-support systems. In this paper, we propose, for the first time in workflow analysis, a Multi-Stage Temporal Convolutional Network (MS-TCN) that performs hierarchical prediction refinement for surgical phase recognition. Causal, dilated convolutions allow for a large receptive field and online inference with smooth predictions even during ambiguous transitions. Our method is thoroughly evaluated on two datasets of laparoscopic cholecystectomy videos with and without the use of additional surgical tool information. Outperforming various state-of-the-art LSTM approaches, we verify the suitability of the proposed causal MS-TCN for surgical phase recognition.Comment: 10 pages, 2 figure

Temporal coherence-based self-supervised learning for laparoscopic workflow analysis

In order to provide the right type of assistance at the right time, computer-assisted surgery systems need context awareness. To achieve this, methods for surgical workflow analysis are crucial. Currently, convolutional neural networks provide the best performance for video-based workflow analysis tasks. For training such networks, large amounts of annotated data are necessary. However, collecting a sufficient amount of data is often costly, time-consuming, and not always feasible. In this paper, we address this problem by presenting and comparing different approaches for self-supervised pretraining of neural networks on unlabeled laparoscopic videos using temporal coherence. We evaluate our pretrained networks on Cholec80, a publicly available dataset for surgical phase segmentation, on which a maximum F1 score of 84.6 was reached. Furthermore, we were able to achieve an increase of the F1 score of up to 10 points when compared to a non-pretrained neural network.Comment: Accepted at the Workshop on Context-Aware Operating Theaters (OR 2.0), a MICCAI satellite even

Human Pose Estimation on Privacy-Preserving Low-Resolution Depth Images

Human pose estimation (HPE) is a key building block for developing AI-based context-aware systems inside the operating room (OR). The 24/7 use of images coming from cameras mounted on the OR ceiling can however raise concerns for privacy, even in the case of depth images captured by RGB-D sensors. Being able to solely use low-resolution privacy-preserving images would address these concerns and help scale up the computer-assisted approaches that rely on such data to a larger number of ORs. In this paper, we introduce the problem of HPE on low-resolution depth images and propose an end-to-end solution that integrates a multi-scale super-resolution network with a 2D human pose estimation network. By exploiting intermediate feature-maps generated at different super-resolution, our approach achieves body pose results on low-resolution images (of size 64x48) that are on par with those of an approach trained and tested on full resolution images (of size 640x480).Comment: Published at MICCAI-201

Artificial Intelligence and Surgery: Ethical Dilemmas and Open Issues

Background: Artificial Intelligence (AI) applications aiming to support surgical decision-making processes are generating novel threats to ethical surgical care. To understand and address these threates, we summarize the main ethical issues that may arise from applying AI to surgery, starting from the Ethics Guidelines for Trustworthy Artificial Intelligence framework recently promoted by the European Commission. Study Design: A modified Delphi process has been employed to achieve expert consensus. Results: The main ethical issues that arise from applying AI to surgery, described in detail herein, relate to human agency, accountability for errors, technical robustness, privacy and data governance, transparency, diversity, non-discrimination, and fairness. It may be possible to address many of these ethical issues by expanding the breadth of surgical AI research to focus on implementation science. The potential for AI to disrupt surgical practice suggests that formal digital health education is becoming increasingly important for surgeons and surgical trainees. Conclusions: A multidisciplinary focus on implementation science and digital health education is desirable to balance opportunities offered by emerging AI technologies and respect for the ethical principles of a patient-centric philosophy

Surgical Data Science - from Concepts toward Clinical Translation

Recent developments in data science in general and machine learning in particular have transformed the way experts envision the future of surgery. Surgical Data Science (SDS) is a new research field that aims to improve the quality of interventional healthcare through the capture, organization, analysis and modeling of data. While an increasing number of data-driven approaches and clinical applications have been studied in the fields of radiological and clinical data science, translational success stories are still lacking in surgery. In this publication, we shed light on the underlying reasons and provide a roadmap for future advances in the field. Based on an international workshop involving leading researchers in the field of SDS, we review current practice, key achievements and initiatives as well as available standards and tools for a number of topics relevant to the field, namely (1) infrastructure for data acquisition, storage and access in the presence of regulatory constraints, (2) data annotation and sharing and (3) data analytics. We further complement this technical perspective with (4) a review of currently available SDS products and the translational progress from academia and (5) a roadmap for faster clinical translation and exploitation of the full potential of SDS, based on an international multi-round Delphi process