Jie Ying Wu

Hao Ding, Jintan Zhang, Peter Kazanzides et al.

Vision-based segmentation of the robotic tool during robot-assisted surgery enables downstream applications, such as augmented reality feedback, while allowing for inaccuracies in robot kinematics. With the introduction of deep learning, many methods were presented to solve instrument segmentation directly and solely from images. While these approaches made remarkable progress on benchmark datasets, fundamental challenges pertaining to their robustness remain. We present CaRTS, a causality-driven robot tool segmentation algorithm, that is designed based on a complementary causal model of the robot tool segmentation task. Rather than directly inferring segmentation masks from observed images, CaRTS iteratively aligns tool models with image observations by updating the initially incorrect robot kinematic parameters through forward kinematics and differentiable rendering to optimize image feature similarity end-to-end. We benchmark CaRTS with competing techniques on both synthetic as well as real data from the dVRK, generated in precisely controlled scenarios to allow for counterfactual synthesis. On training-domain test data, CaRTS achieves a Dice score of 93.4 that is preserved well (Dice score of 91.8) when tested on counterfactually altered test data, exhibiting low brightness, smoke, blood, and altered background patterns. This compares favorably to Dice scores of 95.0 and 86.7, respectively, of the SOTA image-based method. Future work will involve accelerating CaRTS to achieve video framerate and estimating the impact occlusion has in practice. Despite these limitations, our results are promising: In addition to achieving high segmentation accuracy, CaRTS provides estimates of the true robot kinematics, which may benefit applications such as force estimation. Code is available at: https://github.com/hding2455/CaRTS

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.

Hao Ding, Jie Ying Wu, Zhaoshuo Li et al.

Purpose: Vision-based robot tool segmentation plays a fundamental role in surgical robots and downstream tasks. CaRTS, based on a complementary causal model, has shown promising performance in unseen counterfactual surgical environments in the presence of smoke, blood, etc. However, CaRTS requires over 30 iterations of optimization to converge for a single image due to limited observability. Method: To address the above limitations, we take temporal relation into consideration and propose a temporal causal model for robot tool segmentation on video sequences. We design an architecture named Temporally Constrained CaRTS (TC-CaRTS). TC-CaRTS has three novel modules to complement CaRTS - temporal optimization pipeline, kinematics correction network, and spatial-temporal regularization. Results: Experiment results show that TC-CaRTS requires much fewer iterations to achieve the same or better performance as CaRTS. TC- CaRTS also has the same or better performance in different domains compared to CaRTS. All three modules are proven to be effective. Conclusion: We propose TC-CaRTS, which takes advantage of temporal constraints as additional observability. We show that TC-CaRTS outperforms prior work in the robot tool segmentation task with improved convergence speed on test datasets from different domains.

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.

Yue Yang, Fabian Necker, Christoph Leuze et al.

Purpose: In this paper, we develop and clinically evaluate a depth-only, markerless augmented reality (AR) registration pipeline on a head-mounted display, and assess accuracy across small or low-curvature anatomies in real-life operative settings. Methods: On HoloLens 2, we align Articulated HAnd Tracking (AHAT) depth to Computed Tomography (CT)-derived skin meshes via (i) depth-bias correction, (ii) brief human-in-the-loop initialization, (iii) global and local registration. We validated the surface-tracing error metric by comparing "skin-to-bone" relative distances to CT ground truth on leg and foot models, using an AR-tracked tool. We then performed seven intraoperative target trials (feet x2, ear x3, leg x2) during the initial stage of fibula free-flap harvest and mandibular reconstruction surgery, and collected 500+ data per trial. Results: Preclinical validation showed tight agreement between AR-traced and CT distances (leg: median |Delta d| 0.78 mm, RMSE 0.97 mm; feet: 0.80 mm, 1.20 mm). Clinically, per-point error had a median of 3.9 mm. Median errors by anatomy were 3.2 mm (feet), 4.3 mm (ear), and 5.3 mm (lower leg), with 5 mm coverage 92-95%, 84-90%, and 72-86%, respectively. Feet vs. lower leg differed significantly (Delta median ~1.1 mm; p < 0.001). Conclusion: A depth-only, markerless AR pipeline on HMDs achieved ~3-4 mm median error across feet, ear, and lower leg in live surgical settings without fiducials, approaching typical clinical error thresholds for moderate-risk tasks. Human-guided initialization plus global-to-local registration enabled accurate alignment on small or low-curvature targets, improving the clinical readiness of markerless AR guidance.

Haoying Zhou, Hao Yang, Brendan Burkhart et al.

The da Vinci Research Kit (dVRK) is widely used for research in robot-assisted surgery, but most modeling and control methods target the first-generation dVRK Classic. The recently introduced dVRK-Si, built from da Vinci Si hardware, features a redesigned Patient Side Manipulator (PSM) with substantially larger gravity loading, which can degrade control if unmodeled. This paper presents the first complete kinematic and dynamic modeling framework for the dVRK-Si PSM. We derive a modified DH kinematic model that captures the closed-chain parallelogram mechanism, formulate dynamics via the Euler-Lagrange method, and express inverse dynamics in a linear-in-parameters regressor form. Dynamic parameters are identified from data collected on a periodic excitation trajectory optimized for numerical conditioning and estimated by convex optimization with physical feasibility constraints. Using the identified model, we implement real-time gravity compensation and computed-torque feedforward in the dVRK control stack. Experiments on a physical dVRK-Si show that the gravity compensation reduces steady-state joint errors by 68-84% and decreases end-effector tip drift during static holds from 4.2 mm to 0.7 mm. Computed-torque feedforward further improves transient and position tracking accuracy. For sinusoidal trajectory tracking, computed-torque feedforward reduces position errors by 35% versus gravity-only feedforward and by 40% versus PID-only. The proposed pipeline supports reliable control, high-fidelity simulation, and learning-based automation on the dVRK-Si.

John J. Han, Adam Schmidt, Max Allan et al.

The SCARED dataset is a widely used benchmark for endoscopic depth estimation, offering ground-truth 3D reconstructions captured with a structured light sensor. However, the depth maps for non-keyframe images rely on robot kinematics that introduce substantial pose errors, limiting the reliably labeled portion of the dataset to 35 keyframes. We present SCARED-C, a corrected version of the SCARED dataset that expands the number of reliable RGB-D pairs from 35 to 17,135. Our pipeline applies COLMAP, a Structure-from-Motion system, to re-estimate camera poses for all frames, followed by a scale recovery step that aligns the resulting reconstructions to metric space using the ground-truth keyframe depth maps. We validate the corrected poses through (1) stereo disparity evaluation and (2) monocular depth estimation experiments. The corrected dataset and code are publicly released to the community.

Fangjie Li, Nicholas Kavoussi, Charan Mohan et al.

Purpose: Kidney ureteroscopic navigation is challenging with a steep learning curve. However, current clinical training has major deficiencies, as it requires one-on-one feedback from experts and occurs in the operating room (OR). Therefore, there is a need for a phantom training system with automated feedback to greatly \revision{expand} training opportunities. Methods: We propose a novel, purely ureteroscope video-based scope localization framework that automatically identifies calyces missed by the trainee in a phantom kidney exploration. We use a slow, thorough, prior exploration video of the kidney to generate a reference reconstruction. Then, this reference reconstruction can be used to localize any exploration video of the same phantom. Results: In 15 exploration videos, a total of 69 out of 74 calyces were correctly classified. We achieve < 4mm camera pose localization error. Given the reference reconstruction, the system takes 10 minutes to generate the results for a typical exploration (1-2 minute long). Conclusion: We demonstrate a novel camera localization framework that can provide accurate and automatic feedback for kidney phantom explorations. We show its ability as a valid tool that enables out-of-OR training without requiring supervision from an expert.

Jie Ying Wu, Peter Kazanzides, Mathias Unberath

Purpose Surgical simulations play an increasingly important role in surgeon education and developing algorithms that enable robots to perform surgical subtasks. To model anatomy, Finite Element Method (FEM) simulations have been held as the gold standard for calculating accurate soft-tissue deformation. Unfortunately, their accuracy is highly dependent on the simulation parameters, which can be difficult to obtain. Methods In this work, we investigate how live data acquired during any robotic endoscopic surgical procedure may be used to correct for inaccurate FEM simulation results. Since FEMs are calculated from initial parameters and cannot directly incorporate observations, we propose to add a correction factor that accounts for the discrepancy between simulation and observations. We train a network to predict this correction factor. Results To evaluate our method, we use an open-source da Vinci Surgical System to probe a soft-tissue phantom and replay the interaction in simulation. We train the network to correct for the difference between the predicted mesh position and the measured point cloud. This results in 15-30% improvement in the mean distance, demonstrating the effectiveness of our approach across a large range of simulation parameters. Conclusion We show a first step towards a framework that synergistically combines the benefits of model-based simulation and real-time observations. It corrects discrepancies between simulation and the scene that results from inaccurate modeling parameters. This can provide a more accurate simulation environment for surgeons and better data with which to train algorithms.

Laura Fink, Sing Chun Lee, Jie Ying Wu et al.

With the increasing computational power of today's workstations, real-time physically-based rendering is within reach, rapidly gaining attention across a variety of domains. These have expeditiously applied to medicine, where it is a powerful tool for intuitive 3D data visualization. Embedded devices such as optical see-through head-mounted displays (OST HMDs) have been a trend for medical augmented reality. However, leveraging the obvious benefits of physically-based rendering remains challenging on these devices because of limited computational power, memory usage, and power consumption. We navigate the compromise between device limitations and image quality to achieve reasonable rendering results by introducing a novel light field that can be sampled in real-time on embedded devices. We demonstrate its applications in medicine and discuss limitations of the proposed method. An open-source version of this project is available at https://github.com/lorafib/LumiPath which provides full insight on implementation and exemplary demonstrational material.

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.

Mingxing Rao, Yinhong Qin, Soheil Kolouri et al.

Purpose: In order to produce a surgical gesture recognition system that can support a wide variety of procedures, either a very large annotated dataset must be acquired, or fitted models must generalize to new labels (so called "zero-shot" capability). In this paper we investigate the feasibility of latter option. Methods: Leveraging the Bridge-Prompt framework, we prompt-tune a pre-trained vision-text model (CLIP) for gesture recognition in surgical videos. This can utilize extensive outside video data such as text, but also make use of label meta-data and weakly supervised contrastive losses. Results: Our experiments show that prompt-based video encoder outperforms standard encoders in surgical gesture recognition tasks. Notably, it displays strong performance in zero-shot scenarios, where gestures/tasks that were not provided during the encoder training phase are included in the prediction phase. Additionally, we measure the benefit of inclusion text descriptions in the feature extractor training schema. Conclusion Bridge-Prompt and similar pre-trained+prompt-tuned video encoder models present significant visual representation for surgical robotics, especially in gesture recognition tasks. Given the diverse range of surgical tasks (gestures), the ability of these models to zero-shot transfer without the need for any task (gesture) specific retraining makes them invaluable.

John J. Han, Adam Schmidt, Muhammad Abdullah Jamal et al.

Vision foundation models (VFMs) have emerged as powerful tools for surgical scene understanding. However, current approaches predominantly rely on unimodal RGB pre-training, overlooking the complex 3D geometry inherent to surgical environments. Although several architectures support multimodal or geometry-aware inputs in general computer vision, the benefits of incorporating depth information in surgical settings remain underexplored. We conduct a large-scale empirical study comparing eight ViT-based VFMs that differ in pre-training domain, learning objective, and input modality (RGB vs. RGB-D). For pre-training, we use a curated dataset of 1.4 million robotic surgical images paired with depth maps generated from an off-the-shelf network. We evaluate these models under both frozen-backbone and end-to-end fine-tuning protocols across eight surgical datasets spanning object detection, segmentation, depth estimation, and pose estimation. Our experiments yield several consistent findings. Models incorporating explicit geometric tokenization, such as MultiMAE, substantially outperform unimodal baselines across all tasks. Notably, geometric-aware pre-training enables remarkable data efficiency: models fine-tuned on just 25% of labeled data consistently surpass RGB-only models trained on the full dataset. Importantly, these gains require no architectural or runtime changes at inference; depth is used only during pre-training, making adoption straightforward. These findings suggest that multimodal pre-training offers a viable path towards building more capable surgical vision systems.

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.

Yue Yang, Matthieu Chabanas, Carrie Reale et al.

Positive margins are common in head and neck squamous cell carcinoma, yet intraoperative re-resection is often imprecise because margin locations are typically communicated verbally from pathology. We present an all-in-one augmented reality (AR) system that relocalizes positive margins from a resected specimen to the resection bed and visualizes them in situ using HoloLens 2 depth sensing and fully automated markerless surface registration. In a silicone phantom study with six medical trainees, markerless registration achieved target registration errors comparable to a marker-based baseline (median 1.8 mm vs. 1.7 mm; maximum < 4 mm). In a margin relocalization task, AR guidance reduced error from verbal guidance (median 14.2 mm) to a few millimeters (median 3.2 mm), with all AR localizations within 5 mm error. These results support the feasibility of markerless AR margin guidance for more precise intraoperative re-excision.

Ashkan Shahbazi, Elaheh Akbari, Kyvia Pereira et al.

We introduce SurgFormer, a multiresolution gated transformer for data driven soft tissue simulation on volumetric meshes. High fidelity biomechanical solvers are often too costly for interactive use, so we train SurgFormer on solver generated data to predict nodewise displacement fields at near real time rates. SurgFormer builds a fixed mesh hierarchy and applies repeated multibranch blocks that combine local message passing, coarse global self attention, and pointwise feedforward updates, fused by learned per node, per channel gates to adaptively integrate local and long range information while remaining scalable on large meshes. For cut conditioned simulation, resection information is encoded as a learned cut embedding and provided as an additional input, enabling a unified model for both standard deformation prediction and topology altering cases. We also introduce two surgical simulation datasets generated under a unified protocol with XFEM based supervision: a cholecystectomy resection dataset and an appendectomy manipulation and resection dataset with cut and uncut cases. To our knowledge, this is the first learned volumetric surrogate setting to study XFEM supervised cut conditioned deformation within the same volumetric pipeline as standard deformation prediction. Across diverse baselines, SurgFormer achieves strong accuracy with favorable efficiency, making it a practical backbone for both tasks. {Code, data, and project page: \href{https://mint-vu.github.io/SurgFormer/}{available here}}

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.

Jumanh Atoum, Garrison L. H. Johnston, Nabil Simaan et al.

Recognizing surgical gestures in real-time is a stepping stone towards automated activity recognition, skill assessment, intra-operative assistance, and eventually surgical automation. The current robotic surgical systems provide us with rich multi-modal data such as video and kinematics. While some recent works in multi-modal neural networks learn the relationships between vision and kinematics data, current approaches treat kinematics information as independent signals, with no underlying relation between tool-tip poses. However, instrument poses are geometrically related, and the underlying geometry can aid neural networks in learning gesture representation. Therefore, we propose combining motion invariant measures (curvature and torsion) with vision and kinematics data using a relational graph network to capture the underlying relations between different data streams. We show that gesture recognition improves when combining invariant signals with tool position, achieving 90.3\% frame-wise accuracy on the JIGSAWS suturing dataset. Our results show that motion invariant signals coupled with position are better representations of gesture motion compared to traditional position and quaternion representations. Our results highlight the need for geometric-aware modeling of kinematics for gesture recognition.

Qingyun Yang, Fangjie Li, Jiayi Xu et al.

Head and neck squamous cell carcinoma (HNSCC) has one of the highest rates of recurrence cases among solid malignancies. Recurrence rates can be reduced by improving positive margins localization. Frozen section analysis (FSA) of resected specimens is the gold standard for intraoperative margin assessment. However, because of the complex 3D anatomy and the significant shrinkage of resected specimens, accurate margin relocation from specimen back onto the resection site based on FSA results remains challenging. We propose a novel deformable registration framework that uses both the pre-resection upper surface and the post-resection site of the specimen to incorporate thickness information into the registration process. The proposed method significantly improves target registration error (TRE), demonstrating enhanced adaptability to thicker specimens. In tongue specimens, the proposed framework improved TRE by up to 33% as compared to prior deformable registration. Notably, tongue specimens exhibit complex 3D anatomies and hold the highest clinical significance compared to other head and neck specimens from the buccal and skin. We analyzed distinct deformation behaviors in different specimens, highlighting the need for tailored deformation strategies. To further aid intraoperative visualization, we also integrated this framework with an augmented reality-based auto-alignment system. The combined system can accurately and automatically overlay the deformed 3D specimen mesh with positive margin annotation onto the resection site. With a pilot study of the AR guided framework involving two surgeons, the integrated system improved the surgeons' average target relocation error from 9.8 cm to 4.8 cm.

John J. Han, Jie Ying Wu

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

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].

Anna Zapaishchykova, David Dreizin, Zhaoshuo Li et al.

Pelvic ring disruptions result from blunt injury mechanisms and are often found in patients with multi-system trauma. To grade pelvic fracture severity in trauma victims based on whole-body CT, the Tile AO/OTA classification is frequently used. Due to the high volume of whole-body trauma CTs generated in busy trauma centers, an automated approach to Tile classification would provide substantial value, e.,g., to prioritize the reading queue of the attending trauma radiologist. In such scenario, an automated method should perform grading based on a transparent process and based on interpretable features to enable interaction with human readers and lower their workload by offering insights from a first automated read of the scan. This paper introduces an automated yet interpretable pelvic trauma decision support system to assist radiologists in fracture detection and Tile grade classification. The method operates similarly to human interpretation of CT scans and first detects distinct pelvic fractures on CT with high specificity using a Faster-RCNN model that are then interpreted using a structural causal model based on clinical best practices to infer an initial Tile grade. The Bayesian causal model and finally, the object detector are then queried for likely co-occurring fractures that may have been rejected initially due to the highly specific operating point of the detector, resulting in an updated list of detected fractures and corresponding final Tile grade. Our method is transparent in that it provides finding location and type using the object detector, as well as information on important counterfactuals that would invalidate the system's recommendation and achieves an AUC of 83.3%/85.1% for translational/rotational instability. Despite being designed for human-machine teaming, our approach does not compromise on performance compared to previous black-box approaches.

Jie Ying Wu, Nural Yilmaz, Peter Kazanzides et al.

Measurement of environment interaction forces during robotic minimally-invasive surgery would enable haptic feedback to the surgeon, thereby solving one long-standing limitation. Estimating this force from existing sensor data avoids the challenge of retrofitting systems with force sensors, but is difficult due to mechanical effects such as friction and compliance in the robot mechanism. We have previously shown that neural networks can be trained to estimate the internal robot joint torques, thereby enabling estimation of external forces. In this work, we extend the method to estimate external Cartesian forces and torques, and also present a two-step approach to adapt to the specific surgical setup by compensating for forces due to the interactions between the instrument shaft and cannula seal and between the trocar and patient body. Experiments show that this approach provides estimates of external forces and torques within a mean root-mean-square error (RMSE) of 2 N and 0.08 Nm, respectively. Furthermore, the two-step approach can add as little as 5 minutes to the surgery setup time, with about 4 minutes to collect intraoperative training data and 1 minute to train the second-step network.

Yonghao Long, Jie Ying Wu, Bo Lu et al.

Automatic surgical gesture recognition is fundamentally important to enable intelligent cognitive assistance in robotic surgery. With recent advancement in robot-assisted minimally invasive surgery, rich information including surgical videos and robotic kinematics can be recorded, which provide complementary knowledge for understanding surgical gestures. However, existing methods either solely adopt uni-modal data or directly concatenate multi-modal representations, which can not sufficiently exploit the informative correlations inherent in visual and kinematics data to boost gesture recognition accuracies. In this regard, we propose a novel online approach of multi-modal relational graph network (i.e., MRG-Net) to dynamically integrate visual and kinematics information through interactive message propagation in the latent feature space. In specific, we first extract embeddings from video and kinematics sequences with temporal convolutional networks and LSTM units. Next, we identify multi-relations in these multi-modal embeddings and leverage them through a hierarchical relational graph learning module. The effectiveness of our method is demonstrated with state-of-the-art results on the public JIGSAWS dataset, outperforming current uni-modal and multi-modal methods on both suturing and knot typing tasks. Furthermore, we validated our method on in-house visual-kinematics datasets collected with da Vinci Research Kit (dVRK) platforms in two centers, with consistent promising performance achieved.

Aniruddha Tamhane, Jie Ying Wu, Mathias Unberath

Self-supervised, multi-modal learning has been successful in holistic representation of complex scenarios. This can be useful to consolidate information from multiple modalities which have multiple, versatile uses. Its application in surgical robotics can lead to simultaneously developing a generalised machine understanding of the surgical process and reduce the dependency on quality, expert annotations which are generally difficult to obtain. We develop a self-supervised, multi-modal representation learning paradigm that learns representations for surgical gestures from video and kinematics. We use an encoder-decoder network configuration that encodes representations from surgical videos and decodes them to yield kinematics. We quantitatively demonstrate the efficacy of our learnt representations for gesture recognition (with accuracy between 69.6 % and 77.8 %), transfer learning across multiple tasks (with accuracy between 44.6 % and 64.8 %) and surgeon skill classification (with accuracy between 76.8 % and 81.2 %). Further, we qualitatively demonstrate that our self-supervised representations cluster in semantically meaningful properties (surgeon skill and gestures).