Jecia Z. Y. Mao

Jecia Z. Y. Mao, Francis X. Creighton, Russell H. Taylor et al.

We introduce a speech-guided embodied agent framework for video-guided skull base surgery that dynamically executes perception and image-guidance tasks in response to surgeon queries. The proposed system integrates natural language interaction with real-time visual perception directly on live intraoperative video streams, thereby enabling surgeons to request computational assistance without disengaging from operative tasks. Unlike conventional image-guided navigation systems that rely on external optical trackers and additional hardware setup, the framework operates purely on intraoperative video. The system begins with interactive segmentation and labeling of the surgical instrument. The segmented instrument is then used as a spatial anchor that is autonomously tracked in the video stream to support downstream workflows, including anatomical segmentation, interactive registration of preoperative 3D models, monocular video-based estimation of the surgical tool pose, and support image guidance through real-time anatomical overlays.We evaluate the proposed system in video-guided skull base surgery scenarios and benchmark its tracking performance against a commercially available optical tracking system. Results demonstrate that speech-guided embodied agents can achieve competitive spatial accuracy while improving workflow integration and enabling rapid deployment of video-guided surgical systems.

Jecia Z. Y. Mao, Francis X Creighton, Russell H Taylor et al.

Accurate segmentation and tracking of relevant elements of the surgical scene is crucial to enable context-aware intraoperative assistance and decision making. Current solutions remain tethered to domain-specific, supervised models that rely on labeled data and required domain-specific data to adapt to new surgical scenarios and beyond predefined label categories. Recent advances in prompt-driven vision foundation models (VFM) have enabled open-set, zero-shot segmentation across heterogeneous medical images. However, dependence of these models on manual visual or textual cues restricts their deployment in introperative surgical settings. We introduce a speech-guided collaborative perception (SCOPE) framework that integrates reasoning capabilities of large language model (LLM) with perception capabilities of open-set VFMs to support on-the-fly segmentation, labeling and tracking of surgical instruments and anatomy in intraoperative video streams. A key component of this framework is a collaborative perception agent, which generates top candidates of VFM-generated segmentation and incorporates intuitive speech feedback from clinicians to guide the segmentation of surgical instruments in a natural human-machine collaboration paradigm. Afterwards, instruments themselves serve as interactive pointers to label additional elements of the surgical scene. We evaluated our proposed framework on a subset of publicly available Cataract1k dataset and an in-house ex-vivo skull-base dataset to demonstrate its potential to generate on-the-fly segmentation and tracking of surgical scene. Furthermore, we demonstrate its dynamic capabilities through a live mock ex-vivo experiment. This human-AI collaboration paradigm showcase the potential of developing adaptable, hands-free, surgeon-centric tools for dynamic operating-room environments.