Jie Ying Wu

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.

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.