Shuojue Yang

Guotai Wang, Xiangde Luo, Ran Gu et al.

Background and Objective: Open-source deep learning toolkits are one of the driving forces for developing medical image segmentation models. Existing toolkits mainly focus on fully supervised segmentation and require full and accurate pixel-level annotations that are time-consuming and difficult to acquire for segmentation tasks, which makes learning from imperfect labels highly desired for reducing the annotation cost. We aim to develop a new deep learning toolkit to support annotation-efficient learning for medical image segmentation. Methods: Our proposed toolkit named PyMIC is a modular deep learning library for medical image segmentation tasks. In addition to basic components that support development of high-performance models for fully supervised segmentation, it contains several advanced components tailored for learning from imperfect annotations, such as loading annotated and unannounced images, loss functions for unannotated, partially or inaccurately annotated images, and training procedures for co-learning between multiple networks, etc. PyMIC supports development of semi-supervised, weakly supervised and noise-robust learning methods for medical image segmentation. Results: We present several illustrative medical image segmentation tasks based on PyMIC: (1) Achieving competitive performance on fully supervised learning; (2) Semi-supervised cardiac structure segmentation with only 10% training images annotated; (3) Weakly supervised segmentation using scribble annotations; and (4) Learning from noisy labels for chest radiograph segmentation. Conclusions: The PyMIC toolkit is easy to use and facilitates efficient development of medical image segmentation models with imperfect annotations. It is modular and flexible, which enables researchers to develop high-performance models with low annotation cost. The source code is available at: https://github.com/HiLab-git/PyMIC.

Daiyun Shen, Shuojue Yang, Chang Han Low et al.

Surgical instrument pose estimation provides crucial information for promising applications, including autonomous robotic surgery, skill assessment, and standardization of surgical workflow. However, this task remains highly challenging due to high precision requirements, frequent occlusions, textureless instruments, scarcity of depth information and very limited annotated data. These constraints often lead to unsatisfactory performance when employing general object pose estimation approaches to surgical scenarios. To address these issues, we first construct a new dataset SynSurg6D, to alleviate the data shortage in this task. We further propose SurfSurg6D, a dense-correspondence framework tailored for surgical instrument pose estimation. Experimental results on the SurgRIPE, EndoVis2018 and SurgPose datasets demonstrate that the introduction of our generated dataset SynSurg6D is able to diversify the pose distributions, thus enhancing the performance of existing approaches. Furthermore, SurfSurg6D outperforms existing methods, providing a robust solution for precise and efficient RGB-only pose estimation.

Shuojue Yang, Zijian Wu, Chengjiaao Liao et al.

High-quality and controllable digital twins of surgical instruments are critical for Real2Sim in robot-assisted surgery, as they enable realistic simulation, synthetic data generation, and perception learning under novel poses. We present Instrument-Splatting++, a monocular 3D Gaussian Splatting (3DGS) framework that reconstructs surgical instruments as a fully controllable Gaussian asset with high fidelity. Our pipeline starts with part-wise geometry pretraining that injects CAD priors into Gaussian primitives and equips the representation with part-aware semantic rendering. Built on the pretrained model, we propose a semantics-aware pose estimation and tracking (SAPET) method to recover per-frame 6-DoF pose and joint angles from unposed endoscopic videos, where a gripper-tip network trained purely from synthetic semantics provides robust supervision and a loose regularization suppresses singular articulations. Finally, we introduce Robust Texture Learning (RTL), which alternates pose refinement and robust appearance optimization, mitigating pose noise during texture learning. The proposed framework can perform pose estimation and learn realistic texture from unposed videos. We validate our method on sequences extracted from EndoVis17/18, SAR-RARP, and an in-house dataset, showing superior photometric quality and improved geometric accuracy over state-of-the-art baselines. We further demonstrate a downstream keypoint detection task where unseen-pose data augmentation from our controllable instrument Gaussian improves performance.

Qian Li, Shuojue Yang, Daiyun Shen et al.

High-fidelity reconstruction of surgical scene is a fundamentally crucial task to support many applications, such as intra-operative navigation and surgical education. However, most existing methods assume the ideal surgical scenarios - either focus on dynamic reconstruction with deforming tissue yet assuming a given fixed camera pose, or allow endoscope movement yet reconstructing the static scenes. In this paper, we target at a more realistic yet challenging setup - free-pose reconstruction with a moving camera for highly dynamic surgical scenes. Meanwhile, we take the first step to introduce Gaussian Splitting (GS) technique to tackle this challenging setting and propose a novel GS-based framework for fast reconstruction, termed \textit{Free-DyGS}. Concretely, our model embraces a novel scene initialization in which a pre-trained Sparse Gaussian Regressor (SGR) can efficiently parameterize the initial attributes. For each subsequent frame, we propose to jointly optimize the deformation model and 6D camera poses in a frame-by-frame manner, easing training given the limited deformation differences between consecutive frames. A Scene Expansion scheme is followed to expand the GS model for the unseen regions introduced by the moving camera. Moreover, the framework is equipped with a novel Retrospective Deformation Recapitulation (RDR) strategy to preserve the entire-clip deformations throughout the frame-by-frame training scheme. The efficacy of the proposed Free-DyGS is substantiated through extensive experiments on two datasets: StereoMIS and Hamlyn datasets. The experimental outcomes underscore that Free-DyGS surpasses other advanced methods in both rendering accuracy and efficiency. Code will be available.

Bohan Li, Shuojue Yang, Baorui Peng et al.

Action-conditioned surgical video generation is a critical yet highly challenging problem for robotic surgery. The core difficulty is that low-dimensional control vectors must precisely govern complex image-space evolution. In this work, we propose a kinematic-to-visual lifting paradigm that converts articulated kinematics into a unified set of five image-aligned control modalities. Building on this representation, we introduce a hierarchically routed visual control framework that selectively activates the most relevant control modalities and motion scales. Instead of uniformly applying all control signals, our model performs hierarchical routing to dynamically allocate conditioning capacity. We further design kinematic-prior-guided routing loss functions to ensure physically meaningful, temporally stable, and efficient expert utilization. To improve efficiency, we propose a budgeted training and inference scheme that leverages routing-induced sparsity. By selectively discarding low-significance control pathways during training and execution, our approach enables adaptive computation that is complementary to standard distillation. We additionally construct a new benchmark with curated articulated annotations, obtained through human-in-the-loop semantic labeling and differentiable pose tracking, providing realistic supervision for action-conditioned surgical video generation. Extensive experiments demonstrate that our method consistently improves action faithfulness, visual fidelity, and cross-domain generalization over diverse baselines. Moreover, our efficient variant achieves substantial reductions in latency while maintaining strong control accuracy.

Shuojue Yang, Zijian Wu, Mingxuan Hong et al.

Real2Sim is becoming increasingly important with the rapid development of surgical artificial intelligence (AI) and autonomy. In this work, we propose a novel Real2Sim methodology, Instrument-Splatting, that leverages 3D Gaussian Splatting to provide fully controllable 3D reconstruction of surgical instruments from monocular surgical videos. To maintain both high visual fidelity and manipulability, we introduce a geometry pre-training to bind Gaussian point clouds on part mesh with accurate geometric priors and define a forward kinematics to control the Gaussians as flexible as real instruments. Afterward, to handle unposed videos, we design a novel instrument pose tracking method leveraging semantics-embedded Gaussians to robustly refine per-frame instrument poses and joint states in a render-and-compare manner, which allows our instrument Gaussian to accurately learn textures and reach photorealistic rendering. We validated our method on 2 publicly released surgical videos and 4 videos collected on ex vivo tissues and green screens. Quantitative and qualitative evaluations demonstrate the effectiveness and superiority of the proposed method.

Zijian Wu, Shuojue Yang, Yueming Jin et al.

In robot-assisted laparoscopic radical prostatectomy (RALP), the location of the instrument tip is important to register the ultrasound frame with the laparoscopic camera frame. A long-standing limitation is that the instrument tip position obtained from the da Vinci API is inaccurate and requires hand-eye calibration. Thus, directly computing the position of the tool tip in the camera frame using the vision-based method becomes an attractive solution. Besides, surgical instrument tip detection is the key component of other tasks, like surgical skill assessment and surgery automation. However, this task is challenging due to the small size of the tool tip and the articulation of the surgical instrument. Surgical instrument segmentation becomes relatively easy due to the emergence of the Segmentation Foundation Model, i.e., Segment Anything. Based on this advancement, we explore the deep learning-based surgical instrument tip detection approach that takes the part-level instrument segmentation mask as input. Comparison experiments with a hand-crafted image-processing approach demonstrate the superiority of the proposed method on simulated and real datasets.

Qian Li, Feng Liu, Shuojue Yang et al.

Laparoscopic liver surgery, while minimally invasive, poses significant challenges in accurately identifying critical anatomical structures. Augmented reality (AR) systems, integrating MRI/CT with laparoscopic images based on 2D-3D registration, offer a promising solution for enhancing surgical navigation. A vital aspect of the registration progress is the precise detection of curvilinear anatomical landmarks in laparoscopic images. In this paper, we propose BCRNet (Bezier Curve Refinement Net), a novel framework that significantly enhances landmark detection in laparoscopic liver surgery primarily via the Bezier curve refinement strategy. The framework starts with a Multi-modal Feature Extraction (MFE) module designed to robustly capture semantic features. Then we propose Adaptive Curve Proposal Initialization (ACPI) to generate pixel-aligned Bezier curves and confidence scores for reliable initial proposals. Additionally, we design the Hierarchical Curve Refinement (HCR) mechanism to enhance these proposals iteratively through a multi-stage process, capturing fine-grained contextual details from multi-scale pixel-level features for precise Bezier curve adjustment. Extensive evaluations on the L3D and P2ILF datasets demonstrate that BCRNet outperforms state-of-the-art methods, achieving significant performance improvements. Code will be available.