Christian Heiliger

Lennart Bastian, Tobias Czempiel, Christian Heiliger et al.

The surgical operating room (OR) presents many opportunities for automation and optimization. Videos from various sources in the OR are becoming increasingly available. The medical community seeks to leverage this wealth of data to develop automated methods to advance interventional care, lower costs, and improve overall patient outcomes. Existing datasets from OR room cameras are thus far limited in size or modalities acquired, leaving it unclear which sensor modalities are best suited for tasks such as recognizing surgical action from videos. This study demonstrates that surgical action recognition performance can vary depending on the image modalities used. We perform a methodical analysis on several commonly available sensor modalities, presenting two fusion approaches that improve classification performance. The analyses are carried out on a set of multi-view RGB-D video recordings of 18 laparoscopic procedures.

Kun Yuan, Tingxuan Chen, Shi Li et al.

The complexity and diversity of surgical workflows, driven by heterogeneous operating room settings, institutional protocols, and anatomical variability, present a significant challenge in developing generalizable models for cross-institutional and cross-procedural surgical understanding. While recent surgical foundation models pretrained on large-scale vision-language data offer promising transferability, their zero-shot performance remains constrained by domain shifts, limiting their utility in unseen surgical environments. To address this, we introduce Surgical Phase Anywhere (SPA), a lightweight framework for versatile surgical workflow understanding that adapts foundation models to institutional settings with minimal annotation. SPA leverages few-shot spatial adaptation to align multi-modal embeddings with institution-specific surgical scenes and phases. It also ensures temporal consistency through diffusion modeling, which encodes task-graph priors derived from institutional procedure protocols. Finally, SPA employs dynamic test-time adaptation, exploiting the mutual agreement between multi-modal phase prediction streams to adapt the model to a given test video in a self-supervised manner, enhancing the reliability under test-time distribution shifts. SPA is a lightweight adaptation framework, allowing hospitals to rapidly customize phase recognition models by defining phases in natural language text, annotating a few images with the phase labels, and providing a task graph defining phase transitions. The experimental results show that the SPA framework achieves state-of-the-art performance in few-shot surgical phase recognition across multiple institutions and procedures, even outperforming full-shot models with 32-shot labeled data. Code is available at https://github.com/CAMMA-public/SPA

Maximilian Fehrentz, Alexander Winkler, Thomas Heiliger et al.

We introduce BridgeSplat, a novel approach for deformable surgical navigation that couples intraoperative 3D reconstruction with preoperative CT data to bridge the gap between surgical video and volumetric patient data. Our method rigs 3D Gaussians to a CT mesh, enabling joint optimization of Gaussian parameters and mesh deformation through photometric supervision. By parametrizing each Gaussian relative to its parent mesh triangle, we enforce alignment between Gaussians and mesh and obtain deformations that can be propagated back to update the CT. We demonstrate BridgeSplat's effectiveness on visceral pig surgeries and synthetic data of a human liver under simulation, showing sensible deformations of the preoperative CT on monocular RGB data. Code, data, and additional resources can be found at https://maxfehrentz.github.io/ct-informed-splatting/ .