Hubertus Feussner

Tobias Rueckert, Raphaela Maerkl, David Rauber et al.

Robotic- and computer-assisted minimally invasive surgery (RAMIS) is increasingly relying on computer vision methods for reliable instrument recognition and surgical workflow understanding. Developing such systems often requires large, well-annotated datasets, but existing resources often address isolated tasks, neglect temporal dependencies, or lack multi-center variability. We present the Surgical Procedure Phase, Keypoint, and Instrument Recognition (PhaKIR) dataset, comprising eight complete laparoscopic cholecystectomy videos recorded at three medical centers. The dataset provides frame-level annotations for three interconnected tasks: surgical phase recognition (485,875 frames), instrument keypoint estimation (19,435 frames), and instrument instance segmentation (19,435 frames). PhaKIR is, to our knowledge, the first multi-institutional dataset to jointly provide phase labels, instrument pose information, and pixel-accurate instrument segmentations, while also enabling the exploitation of temporal context since full surgical procedure sequences are available. It served as the basis for the PhaKIR Challenge as part of the Endoscopic Vision (EndoVis) Challenge at MICCAI 2024 to benchmark methods in surgical scene understanding, thereby further validating the dataset's quality and relevance. The dataset is publicly available upon request via the Zenodo platform.

Tobias Rueckert, David Rauber, Raphaela Maerkl et al.

Reliable recognition and localization of surgical instruments in endoscopic video recordings are foundational for a wide range of applications in computer- and robot-assisted minimally invasive surgery (RAMIS), including surgical training, skill assessment, and autonomous assistance. However, robust performance under real-world conditions remains a significant challenge. Incorporating surgical context - such as the current procedural phase - has emerged as a promising strategy to improve robustness and interpretability. To address these challenges, we organized the Surgical Procedure Phase, Keypoint, and Instrument Recognition (PhaKIR) sub-challenge as part of the Endoscopic Vision (EndoVis) challenge at MICCAI 2024. We introduced a novel, multi-center dataset comprising thirteen full-length laparoscopic cholecystectomy videos collected from three distinct medical institutions, with unified annotations for three interrelated tasks: surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation. Unlike existing datasets, ours enables joint investigation of instrument localization and procedural context within the same data while supporting the integration of temporal information across entire procedures. We report results and findings in accordance with the BIAS guidelines for biomedical image analysis challenges. The PhaKIR sub-challenge advances the field by providing a unique benchmark for developing temporally aware, context-driven methods in RAMIS and offers a high-quality resource to support future research in surgical scene understanding.

Lena Maier-Hein, Matthias Eisenmann, Duygu Sarikaya et al.

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.

Tobias Czempiel, Magdalini Paschali, Matthias Keicher et al.

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.