Ayberk Acar

Hao Li, Daiwei Lu, Jesse d'Almeida et al.

Monocular depth estimation (MDE) is a critical task to guide autonomous medical robots. However, obtaining absolute (metric) depth from an endoscopy camera in surgical scenes is difficult, which limits supervised learning of depth on real endoscopic images. Current image-level unsupervised domain adaptation methods translate synthetic images with known depth maps into the style of real endoscopic frames and train depth networks using these translated images with their corresponding depth maps. However a domain gap often remains between real and translated synthetic images. In this paper, we present a latent feature alignment method to improve absolute depth estimation by reducing this domain gap in the context of endoscopic videos of the central airway. Our methods are agnostic to the image translation process and focus on the depth estimation itself. Specifically, the depth network takes translated synthetic and real endoscopic frames as input and learns latent domain-invariant features via adversarial learning and directional feature consistency. The evaluation is conducted on endoscopic videos of central airway phantoms with manually aligned absolute depth maps. Compared to state-of-the-art MDE methods, our approach achieves superior performance on both absolute and relative depth metrics, and consistently improves results across various backbones and pretrained weights. Our code is available at https://github.com/MedICL-VU/MDE.

Open-H-Embodiment Consortium, Nigel Nelson, Juo-Tung Chen et al.

Autonomous medical robots hold promise to improve patient outcomes, reduce provider workload, democratize access to care, and enable superhuman precision. However, autonomous medical robotics has been limited by a fundamental data problem: existing medical robotic datasets are small, single-embodiment, and rarely shared openly, restricting the development of foundation models that the field needs to advance. We introduce Open-H-Embodiment, the largest open dataset of medical robotic video with synchronized kinematics to date, spanning more than 49 institutions and multiple robotic platforms including the CMR Versius, Intuitive Surgical's da Vinci, da Vinci Research Kit (dVRK), Rob Surgical BiTrack, Virtual Incision's MIRA, Moon Surgical Maestro, and a variety of custom systems, spanning surgical manipulation, robotic ultrasound, and endoscopy procedures. We demonstrate the research enabled by this dataset through two foundation models. GR00T-H is the first open foundation vision-language-action model for medical robotics, which is the only evaluated model to achieve full end-to-end task completion on a structured suturing benchmark (25% of trials vs. 0% for all others) and achieves 64% average success across a 29-step ex vivo suturing sequence. We also train Cosmos-H-Surgical-Simulator, the first action-conditioned world model to enable multi-embodiment surgical simulation from a single checkpoint, spanning nine robotic platforms and supporting in silico policy evaluation and synthetic data generation for the medical domain. These results suggest that open, large-scale medical robot data collection can serve as critical infrastructure for the research community, enabling advances in robot learning, world modeling, and beyond.

John J. Han, Ayberk Acar, Callahan Henry et al.

Monocular depth estimation (MDE) is a critical component of many medical tracking and mapping algorithms, particularly from endoscopic or laparoscopic video. However, because ground truth depth maps cannot be acquired from real patient data, supervised learning is not a viable approach to predict depth maps for medical scenes. Although self-supervised learning for MDE has recently gained attention, the outputs are difficult to evaluate reliably and each MDE's generalizability to other patients and anatomies is limited. This work evaluates the zero-shot performance of the newly released Depth Anything Model on medical endoscopic and laparoscopic scenes. We compare the accuracy and inference speeds of Depth Anything with other MDE models trained on general scenes as well as in-domain models trained on endoscopic data. Our findings show that although the zero-shot capability of Depth Anything is quite impressive, it is not necessarily better than other models in both speed and performance. We hope that this study can spark further research in employing foundation models for MDE in medical scenes.

Ayberk Acar, Mariana Smith, Lidia Al-Zogbi et al.

Surgical automation requires precise guidance and understanding of the scene. Current methods in the literature rely on bulky depth cameras to create maps of the anatomy, however this does not translate well to space-limited clinical applications. Monocular cameras are small and allow minimally invasive surgeries in tight spaces but additional processing is required to generate 3D scene understanding. We propose a 3D mapping pipeline that uses only RGB images to create segmented point clouds of the target anatomy. To ensure the most precise reconstruction, we compare different structure from motion algorithms' performance on mapping the central airway obstructions, and test the pipeline on a downstream task of tumor resection. In several metrics, including post-procedure tissue model evaluation, our pipeline performs comparably to RGB-D cameras and, in some cases, even surpasses their performance. These promising results demonstrate that automation guidance can be achieved in minimally invasive procedures with monocular cameras. This study is a step toward the complete autonomy of surgical robots.

Hao Yang, Ayberk Acar, Keshuai Xu et al.

Robot-assisted minimally invasive surgery, such as through the da Vinci systems, improves precision and patient outcomes. However, da Vinci systems prior to da Vinci 5, lacked direct force-sensing capabilities, forcing surgeons to operate without the haptic feedback they get through laparoscopy. Our prior work restored force sensing through machine learning-based force estimation for the da Vinci Research Kit (dVRK) Classic. This study extends our previous method to the newer dVRK system, the dVRK-Si. Additionally, we benchmark the performance of the learning-based algorithm against baseline methods (which make simplifying assumptions on the torque) to study how the two systems differ. Results show the learning-based method achieves an average root-mean-square-error (RMSE) of 5.21\%, for the dVRK-Si, which is comparable to the dVRK Classic. In both systems, the learning-based method outperforms baselines, but the difference is much larger in the dVRK-Si. Nonetheless, dVRK-Si force estimation accuracy lags behind the dVRK Classic, with RMSE 2 to 3 times higher. Further analysis reveals poor PID control in the dVRK-Si. We hypothesize that this is due to the lack of gravity compensation, as unlike the dVRK Classic, the dVRK-Si is not mechanically balanced. This study advances the understanding of learning-based force estimation and is the first work to characterize the dynamics of the new dVRK-Si system.

John J. Han, Ayberk Acar, Nicholas Kavoussi et al.

Style transfer is a promising approach to close the sim-to-real gap in medical endoscopy. Rendering synthetic endoscopic videos by traversing pre-operative scans (such as MRI or CT) can generate structurally accurate simulations as well as ground truth camera poses and depth maps. Although image-to-image (I2I) translation models such as CycleGAN can imitate realistic endoscopic images from these simulations, they are unsuitable for video-to-video synthesis due to the lack of temporal consistency, resulting in artifacts between frames. We propose MeshBrush, a neural mesh stylization method to synthesize temporally consistent videos with differentiable rendering. MeshBrush uses the underlying geometry of patient imaging data while leveraging existing I2I methods. With learned per-vertex textures, the stylized mesh guarantees consistency while producing high-fidelity outputs. We demonstrate that mesh stylization is a promising approach for creating realistic simulations for downstream tasks such as training networks and preoperative planning. Although our method is tested and designed for ureteroscopy, its components are transferable to general endoscopic and laparoscopic procedures. The code will be made public on GitHub.

Ayberk Acar, Fangjie Li, Hao Li et al.

Central airway obstruction (CAO) is a life-threatening condition with increasing incidence, caused by tumors in and outside of the airway. Traditional treatment methods such as bronchoscopy and electrocautery can be used to remove the tumor completely; however, these methods carry a high risk of complications. Recent advances allow robotic interventions with lesser risk. The combination of robot interventions with scene understanding and mapping also opens up the possibilities for automation. We present a novel pipeline that enables real-time, semantically informed 3D reconstructions of the central airway using monocular endoscopic video. Our approach combines DROID-SLAM with a segmentation model trained to identify obstructive tissues. The SLAM module reconstructs the 3D geometry of the airway in real time, while the segmentation masks guide the annotation of obstruction regions within the reconstructed point cloud. To validate our pipeline, we evaluate the reconstruction quality using ex vivo models. Qualitative and quantitative results show high similarity between ground truth CT scans and the 3D reconstructions (0.62 mm Chamfer distance). By integrating segmentation directly into the SLAM workflow, our system produces annotated 3D maps that highlight clinically relevant regions in real time. High-speed capabilities of the pipeline allows quicker reconstructions compared to previous work, reflecting the surgical scene more accurately. To the best of our knowledge, this is the first work to integrate semantic segmentation with real-time monocular SLAM for endoscopic CAO scenarios. Our framework is modular and can generalize to other anatomies or procedures with minimal changes, offering a promising step toward autonomous robotic interventions.

Aneeq Zia, Max Berniker, Rogerio Garcia Nespolo et al.

Robotic assisted (RA) surgery promises to transform surgical intervention. Intuitive Surgical is committed to fostering these changes and the machine learning models and algorithms that will enable them. With these goals in mind we have invited the surgical data science community to participate in a yearly competition hosted through the Medical Imaging Computing and Computer Assisted Interventions (MICCAI) conference. With varying changes from year to year, we have challenged the community to solve difficult machine learning problems in the context of advanced RA applications. Here we document the results of these challenges, focusing on surgical tool localization (SurgToolLoc). The publicly released dataset that accompanies these challenges is detailed in a separate paper arXiv:2501.09209 [1].