Guankun Wang

Guankun Wang, Long Bai, Yanan Wu et al.

Endoscopy is a widely used technique for the early detection of diseases or robotic-assisted minimally invasive surgery (RMIS). Numerous deep learning (DL)-based research works have been developed for automated diagnosis or processing of endoscopic view. However, existing DL models may suffer from catastrophic forgetting. When new target classes are introduced over time or cross institutions, the performance of old classes may suffer severe degradation. More seriously, data privacy and storage issues may lead to the unavailability of old data when updating the model. Therefore, it is necessary to develop a continual learning (CL) methodology to solve the problem of catastrophic forgetting in endoscopic image segmentation. To tackle this, we propose a Endoscopy Continual Semantic Segmentation (EndoCSS) framework that does not involve the storage and privacy issues of exemplar data. The framework includes a mini-batch pseudo-replay (MB-PR) mechanism and a self-adaptive noisy cross-entropy (SAN-CE) loss. The MB-PR strategy circumvents privacy and storage issues by generating pseudo-replay images through a generative model. Meanwhile, the MB-PR strategy can also correct the model deviation to the replay data and current training data, which is aroused by the significant difference in the amount of current and replay images. Therefore, the model can perform effective representation learning on both new and old tasks. SAN-CE loss can help model fitting by adjusting the model's output logits, and also improve the robustness of training. Extensive continual semantic segmentation (CSS) experiments on public datasets demonstrate that our method can robustly and effectively address the catastrophic forgetting brought by class increment in endoscopy scenes. The results show that our framework holds excellent potential for real-world deployment in a streaming learning manner.

Xiaopin Zhong, Guankun Wang, Weixiang Liu et al.

As a fundamental computer vision task, crowd counting plays an important role in public safety. Currently, deep learning based head detection is a promising method for crowd counting. However, the highly concerned object detection networks cannot be well applied to this problem for three reasons: (1) Existing loss functions fail to address sample imbalance in highly dense and complex scenes; (2) Canonical object detectors lack spatial coherence in loss calculation, disregarding the relationship between object location and background region; (3) Most of the head detection datasets are only annotated with the center points, i.e. without bounding boxes. To overcome these issues, we propose a novel Mask Focal Loss (MFL) based on heatmap via the Gaussian kernel. MFL provides a unifying framework for the loss functions based on both heatmap and binary feature map ground truths. Additionally, we introduce GTA_Head, a synthetic dataset with comprehensive annotations, for evaluation and comparison. Extensive experimental results demonstrate the superior performance of our MFL across various detectors and datasets, and it can reduce MAE and RMSE by up to 47.03% and 61.99%, respectively. Therefore, our work presents a strong foundation for advancing crowd counting methods based on density estimation.

Jiezhou Chen, Guankun Wang, Weixiang Liu et al.

Head detection provides distribution information of pedestrian, which is crucial for scene statistical analysis, traffic management, and risk assessment and early warning. However, scene complexity and large-scale variation in the real world make accurate detection more difficult. Therefore, we present a modified Yolov8 which improves head detection performance through reinforcing target perception. An Auxiliary Learning Feature Fusion (ALFF) module comprised of LSTM and convolutional blocks is used as the auxiliary task to help the model perceive targets. In addition, we introduce Noise Calibration into Distribution Focal Loss to facilitate model fitting and improve the accuracy of detection. Considering the requirements of high accuracy and speed for the head detection task, our method is adapted with two kinds of backbone, namely Yolov8n and Yolov8m. The results demonstrate the superior performance of our approach in improving detection accuracy and robustness.

Long Bai, Guankun Wang, Jie Wang et al.

In the realm of automated robotic surgery and computer-assisted interventions, understanding robotic surgical activities stands paramount. Existing algorithms dedicated to surgical activity recognition predominantly cater to pre-defined closed-set paradigms, ignoring the challenges of real-world open-set scenarios. Such algorithms often falter in the presence of test samples originating from classes unseen during training phases. To tackle this problem, we introduce an innovative Open-Set Surgical Activity Recognition (OSSAR) framework. Our solution leverages the hyperspherical reciprocal point strategy to enhance the distinction between known and unknown classes in the feature space. Additionally, we address the issue of over-confidence in the closed set by refining model calibration, avoiding misclassification of unknown classes as known ones. To support our assertions, we establish an open-set surgical activity benchmark utilizing the public JIGSAWS dataset. Besides, we also collect a novel dataset on endoscopic submucosal dissection for surgical activity tasks. Extensive comparisons and ablation experiments on these datasets demonstrate the significant outperformance of our method over existing state-of-the-art approaches. Our proposed solution can effectively address the challenges of real-world surgical scenarios. Our code is publicly accessible at https://github.com/longbai1006/OSSAR.

Rulin Zhou, Guankun Wang, An Wang et al.

Accurate and stable field-of-view (FoV) guidance is critical for safe and efficient minimally invasive surgery, yet existing approaches often conflate visual attention estimation with downstream camera control or rely on direct object-centric assumptions. In this work, we formulate surgical attention tracking as a spatio-temporal learning problem and model surgeon focus as a dense attention heatmap, enabling continuous and interpretable frame-wise FoV guidance. We propose SurgAtt-Tracker, a holistic framework that robustly tracks surgical attention by exploiting temporal coherence through proposal-level reranking and motion-aware refinement, rather than direct regression. To support systematic training and evaluation, we introduce SurgAtt-1.16M, a large-scale benchmark with a clinically grounded annotation protocol that enables comprehensive heatmap-based attention analysis across procedures and institutions. Extensive experiments on multiple surgical datasets demonstrate that SurgAtt-Tracker consistently achieves state-of-the-art performance and strong robustness under occlusion, multi-instrument interference, and cross-domain settings. Beyond attention tracking, our approach provides a frame-wise FoV guidance signal that can directly support downstream robotic FoV planning and automatic camera control.

Guankun Wang, Long Bai, Hongliang Ren

Reasoning capability has significantly advanced complex logical inference and robotic decision-making in general domains. However, its potential in the Artificial Intelligence (AI) copilot robot-particularly implemented based on the Vision-Language-Action (VLA) model-remains unexplored in endoscopic surgery. Effective reasoning should enable AI copilot robots to integrate multimodal cues, interpret surgical intent, and infer hidden tissue dynamics, thereby alleviating intraoperative uncertainty and cognitive burden on surgeons. Properly implemented, reasoning-driven autonomy can transform AI copilot robots from reactive executors into cognitive collaborators, enhancing precision, safety, and sustainability in clinical practice.

Yiming Huang, Long Bai, Beilei Cui et al.

In contemporary surgical research and practice, accurately comprehending 3D surgical scenes with text-promptable capabilities is particularly crucial for surgical planning and real-time intra-operative guidance, where precisely identifying and interacting with surgical tools and anatomical structures is paramount. However, existing works focus on surgical vision-language model (VLM), 3D reconstruction, and segmentation separately, lacking support for real-time text-promptable 3D queries. In this paper, we present SurgTPGS, a novel text-promptable Gaussian Splatting method to fill this gap. We introduce a 3D semantics feature learning strategy incorporating the Segment Anything model and state-of-the-art vision-language models. We extract the segmented language features for 3D surgical scene reconstruction, enabling a more in-depth understanding of the complex surgical environment. We also propose semantic-aware deformation tracking to capture the seamless deformation of semantic features, providing a more precise reconstruction for both texture and semantic features. Furthermore, we present semantic region-aware optimization, which utilizes regional-based semantic information to supervise the training, particularly promoting the reconstruction quality and semantic smoothness. We conduct comprehensive experiments on two real-world surgical datasets to demonstrate the superiority of SurgTPGS over state-of-the-art methods, highlighting its potential to revolutionize surgical practices. SurgTPGS paves the way for developing next-generation intelligent surgical systems by enhancing surgical precision and safety. Our code is available at: https://github.com/lastbasket/SurgTPGS.

Guankun Wang, Tian-Ao Ren, Jiewen Lai et al.

Video-assisted transoral tracheal intubation (TI) necessitates using an endoscope that helps the physician insert a tracheal tube into the glottis instead of the esophagus. The growing trend of robotic-assisted TI would require a medical robot to distinguish anatomical features like an experienced physician which can be imitated by utilizing supervised deep-learning techniques. However, the real datasets of oropharyngeal organs are often inaccessible due to limited open-source data and patient privacy. In this work, we propose a domain adaptive Sim-to-Real framework called IoU-Ranking Blend-ArtFlow (IRB-AF) for image segmentation of oropharyngeal organs. The framework includes an image blending strategy called IoU-Ranking Blend (IRB) and style-transfer method ArtFlow. Here, IRB alleviates the problem of poor segmentation performance caused by significant datasets domain differences; while ArtFlow is introduced to reduce the discrepancies between datasets further. A virtual oropharynx image dataset generated by the SOFA framework is used as the learning subject for semantic segmentation to deal with the limited availability of actual endoscopic images. We adapted IRB-AF with the state-of-the-art domain adaptive segmentation models. The results demonstrate the superior performance of our approach in further improving the segmentation accuracy and training stability.

Guankun Wang, Long Bai, Wan Jun Nah et al.

Recent advancements in Surgical Visual Question Answering (Surgical-VQA) and related region grounding have shown great promise for robotic and medical applications, addressing the critical need for automated methods in personalized surgical mentorship. However, existing models primarily provide simple structured answers and struggle with complex scenarios due to their limited capability in recognizing long-range dependencies and aligning multimodal information. In this paper, we introduce Surgical-LVLM, a novel personalized large vision-language model tailored for complex surgical scenarios. Leveraging the pre-trained large vision-language model and specialized Visual Perception LoRA (VP-LoRA) blocks, our model excels in understanding complex visual-language tasks within surgical contexts. In addressing the visual grounding task, we propose the Token-Interaction (TIT) module, which strengthens the interaction between the grounding module and the language responses of the Large Visual Language Model (LVLM) after projecting them into the latent space. We demonstrate the effectiveness of Surgical-LVLM on several benchmarks, including EndoVis-17-VQLA, EndoVis-18-VQLA, and a newly introduced EndoVis Conversations dataset, which sets new performance standards. Our work contributes to advancing the field of automated surgical mentorship by providing a context-aware solution.

Qiaozhi Tan, Long Bai, Guankun Wang et al.

Wireless capsule endoscopy (WCE) is a non-invasive diagnostic procedure that enables visualization of the gastrointestinal (GI) tract. Deep learning-based methods have shown effectiveness in disease screening using WCE data, alleviating the burden on healthcare professionals. However, existing capsule endoscopy classification methods mostly rely on pre-defined categories, making it challenging to identify and classify out-of-distribution (OOD) data, such as undefined categories or anatomical landmarks. To address this issue, we propose the Endoscopy Out-of-Distribution (EndoOOD) framework, which aims to effectively handle the OOD detection challenge in WCE diagnosis. The proposed framework focuses on improving the robustness and reliability of WCE diagnostic capabilities by incorporating uncertainty-aware mixup training and long-tailed in-distribution (ID) data calibration techniques. Additionally, virtual-logit matching is employed to accurately distinguish between OOD and ID data while minimizing information loss. To assess the performance of our proposed solution, we conduct evaluations and comparisons with 12 state-of-the-art (SOTA) methods using two publicly available datasets. The results demonstrate the effectiveness of the proposed framework in enhancing diagnostic accuracy and supporting clinical decision-making.

Long Bai, Boyi Ma, Ruohan Wang et al.

Surgical workflow recognition is vital for automating tasks, supporting decision-making, and training novice surgeons, ultimately improving patient safety and standardizing procedures. However, data corruption can lead to performance degradation due to issues like occlusion from bleeding or smoke in surgical scenes and problems with data storage and transmission. In this case, we explore a robust graph-based multimodal approach to integrating vision and kinematic data to enhance accuracy and reliability. Vision data captures dynamic surgical scenes, while kinematic data provides precise movement information, overcoming limitations of visual recognition under adverse conditions. We propose a multimodal Graph Representation network with Adversarial feature Disentanglement (GRAD) for robust surgical workflow recognition in challenging scenarios with domain shifts or corrupted data. Specifically, we introduce a Multimodal Disentanglement Graph Network that captures fine-grained visual information while explicitly modeling the complex relationships between vision and kinematic embeddings through graph-based message modeling. To align feature spaces across modalities, we propose a Vision-Kinematic Adversarial framework that leverages adversarial training to reduce modality gaps and improve feature consistency. Furthermore, we design a Contextual Calibrated Decoder, incorporating temporal and contextual priors to enhance robustness against domain shifts and corrupted data. Extensive comparative and ablation experiments demonstrate the effectiveness of our model and proposed modules. Moreover, our robustness experiments show that our method effectively handles data corruption during storage and transmission, exhibiting excellent stability and robustness. Our approach aims to advance automated surgical workflow recognition, addressing the complexities and dynamism inherent in surgical procedures.

Chi Kit Ng, Long Bai, Guankun Wang et al.

In endoscopic procedures, autonomous tracking of abnormal regions and following circumferential cutting markers can significantly reduce the cognitive burden on endoscopists. However, conventional model-based pipelines are fragile for each component (e.g., detection, motion planning) requires manual tuning and struggles to incorporate high-level endoscopic intent, leading to poor generalization across diverse scenes. Vision-Language-Action (VLA) models, which integrate visual perception, language grounding, and motion planning within an end-to-end framework, offer a promising alternative by semantically adapting to surgeon prompts without manual recalibration. Despite their potential, applying VLA models to robotic endoscopy presents unique challenges due to the complex and dynamic anatomical environments of the gastrointestinal (GI) tract. To address this, we introduce EndoVLA, designed specifically for continuum robots in GI interventions. Given endoscopic images and surgeon-issued tracking prompts, EndoVLA performs three core tasks: (1) polyp tracking, (2) delineation and following of abnormal mucosal regions, and (3) adherence to circular markers during circumferential cutting. To tackle data scarcity and domain shifts, we propose a dual-phase strategy comprising supervised fine-tuning on our EndoVLA-Motion dataset and reinforcement fine-tuning with task-aware rewards. Our approach significantly improves tracking performance in endoscopy and enables zero-shot generalization in diverse scenes and complex sequential tasks.

Rulin Zhou, Yingjie Feng, Guankun Wang et al.

Adenoid hypertrophy stands as a common cause of obstructive sleep apnea-hypopnea syndrome in children. It is characterized by snoring, nasal congestion, and growth disorders. Computed Tomography (CT) emerges as a pivotal medical imaging modality, utilizing X-rays and advanced computational techniques to generate detailed cross-sectional images. Within the realm of pediatric airway assessments, CT imaging provides an insightful perspective on the shape and volume of enlarged adenoids. Despite the advances of deep learning methods for medical imaging analysis, there remains an emptiness in the segmentation of adenoid hypertrophy in CT scans. To address this research gap, we introduce TSUBF-Nett (Trans-Spatial UNet-like Network based on Bi-direction Fusion), a 3D medical image segmentation framework. TSUBF-Net is engineered to effectively discern intricate 3D spatial interlayer features in CT scans and enhance the extraction of boundary-blurring features. Notably, we propose two innovative modules within the U-shaped network architecture:the Trans-Spatial Perception module (TSP) and the Bi-directional Sampling Collaborated Fusion module (BSCF).These two modules are in charge of operating during the sampling process and strategically fusing down-sampled and up-sampled features, respectively. Furthermore, we introduce the Sobel loss term, which optimizes the smoothness of the segmentation results and enhances model accuracy. Extensive 3D segmentation experiments are conducted on several datasets. TSUBF-Net is superior to the state-of-the-art methods with the lowest HD95: 7.03, IoU:85.63, and DSC: 92.26 on our own AHSD dataset. The results in the other two public datasets also demonstrate that our methods can robustly and effectively address the challenges of 3D segmentation in CT scans.

Mengya Xu, Wenjin Mo, Guankun Wang et al.

Robot-assisted Endoscopic Submucosal Dissection (ESD) improves the surgical procedure by providing a more comprehensive view through advanced robotic instruments and bimanual operation, thereby enhancing dissection efficiency and accuracy. Accurate prediction of dissection trajectories is crucial for better decision-making, reducing intraoperative errors, and improving surgical training. Nevertheless, predicting these trajectories is challenging due to variable tumor margins and dynamic visual conditions. To address this issue, we create the ESD Trajectory and Confidence Map-based Safety Margin (ETSM) dataset with $1849$ short clips, focusing on submucosal dissection with a dual-arm robotic system. We also introduce a framework that combines optimal dissection trajectory prediction with a confidence map-based safety margin, providing a more secure and intelligent decision-making tool to minimize surgical risks for ESD procedures. Additionally, we propose the Regression-based Confidence Map Prediction Network (RCMNet), which utilizes a regression approach to predict confidence maps for dissection areas, thereby delineating various levels of safety margins. We evaluate our RCMNet using three distinct experimental setups: in-domain evaluation, robustness assessment, and out-of-domain evaluation. Experimental results show that our approach excels in the confidence map-based safety margin prediction task, achieving a mean absolute error (MAE) of only $3.18$. To the best of our knowledge, this is the first study to apply a regression approach for visual guidance concerning delineating varying safety levels of dissection areas. Our approach bridges gaps in current research by improving prediction accuracy and enhancing the safety of the dissection process, showing great clinical significance in practice.

Ruijie Tang, Chi Kit Ng, Kaixuan Wu et al.

In-vivo environments, magnetically actuated soft robots offer advantages such as wireless operation and precise control, showing promising potential for painless detection and therapeutic procedures. We developed a trileg magnetically driven soft robot (TMR) whose multi-legged design enables more flexible gaits and diverse motion patterns. For the silicone made of reconfigurable soft robots, its navigation ability can be separated into sequential motions, namely squatting, rotation, lifting a leg, walking and so on. Its motion and behavior depend on its bending shapes. To bridge motion type description and specific low-level voltage control, we introduced TMR-VLA, an end-to-end multi-modal system for a trileg magnetic soft robot capable of performing hybrid motion types, which is promising for developing a navigation ability by adapting its shape to language-constrained motion types. The TMR-VLA deploys embodied endoluminal localization ability from EndoVLA, and fuses sequential frames and natural language commands as input. Low-level voltage output is generated based on the current observation state and specific motion type description. The result shows the TMR-VLA can predict how the voltage applied to TMR will change the dynamics of a silicon-made soft robot. The TMR-VLA reached a 74% average success rate.

Rui Tang, Haochen Yin, Guankun Wang et al.

Surgical phase recognition plays a critical role in developing intelligent assistance systems for minimally invasive procedures such as Endoscopic Submucosal Dissection (ESD). However, the high visual similarity across different phases and the lack of structural cues in RGB images pose significant challenges. Depth information offers valuable geometric cues that can complement appearance features by providing insights into spatial relationships and anatomical structures. In this paper, we pioneer the use of depth information for surgical phase recognition and propose Geo-RepNet, a geometry-aware convolutional framework that integrates RGB image and depth information to enhance recognition performance in complex surgical scenes. Built upon a re-parameterizable RepVGG backbone, Geo-RepNet incorporates the Depth-Guided Geometric Prior Generation (DGPG) module that extracts geometry priors from raw depth maps, and the Geometry-Enhanced Multi-scale Attention (GEMA) to inject spatial guidance through geometry-aware cross-attention and efficient multi-scale aggregation. To evaluate the effectiveness of our approach, we construct a nine-phase ESD dataset with dense frame-level annotations from real-world ESD videos. Extensive experiments on the proposed dataset demonstrate that Geo-RepNet achieves state-of-the-art performance while maintaining robustness and high computational efficiency under complex and low-texture surgical environments.

Mengya Xu, Wenjin Mo, Guankun Wang et al.

Purpose: Endoscopic surgical environments present challenges for dissection zone segmentation due to unclear boundaries between tissue types, leading to segmentation errors where models misidentify or overlook edges. This study aims to provide precise dissection zone suggestions during endoscopic submucosal dissection (ESD) procedures, enhancing ESD safety. Methods: We propose the Prompted-based Dissection Zone Segmentation (PDZSeg) model, designed to leverage diverse visual prompts such as scribbles and bounding boxes. By overlaying these prompts onto images and fine-tuning a foundational model on a specialized dataset, our approach improves segmentation performance and user experience through flexible input methods. Results: The PDZSeg model was validated using three experimental setups: in-domain evaluation, variability in visual prompt availability, and robustness assessment. Using the ESD-DZSeg dataset, results show that our method outperforms state-of-the-art segmentation approaches. This is the first study to integrate visual prompt design into dissection zone segmentation. Conclusion: The PDZSeg model effectively utilizes visual prompts to enhance segmentation performance and user experience, supported by the novel ESD-DZSeg dataset as a benchmark for dissection zone segmentation in ESD. Our work establishes a foundation for future research.

Guankun Wang, Tian-Ao Ren, Jiewen Lai et al.

Robotic-assisted tracheal intubation requires the robot to distinguish anatomical features like an experienced physician using deep-learning techniques. However, real datasets of oropharyngeal organs are limited due to patient privacy issues, making it challenging to train deep-learning models for accurate image segmentation. We hereby consider generating a new data modality through a virtual environment to assist the training process. Specifically, this work introduces a virtual dataset generated by the Simulation Open Framework Architecture (SOFA) framework to overcome the limited availability of actual endoscopic images. We also propose a domain adaptive Sim-to-Real method for oropharyngeal organ image segmentation, which employs an image blending strategy called IoU-Ranking Blend (IRB) and style-transfer techniques to address discrepancies between datasets. Experimental results demonstrate the superior performance of the proposed approach with domain adaptive models, improving segmentation accuracy and training stability. In the practical application, the trained segmentation model holds great promise for robot-assisted intubation surgery and intelligent surgical navigation.