DARES: Depth Anything in Robotic Endoscopic Surgery with Self-supervised Vector-LoRA of the Foundation Model

Robotic-assisted surgery (RAS) relies on accurate depth estimation for 3D reconstruction and visualization. While foundation models like Depth Anything Models (DAM) show promise, directly applying them to surgery often yields suboptimal results. Fully fine-tuning on limited surgical data can cause overfitting and catastrophic forgetting, compromising model robustness and generalization. Although Low-Rank Adaptation (LoRA) addresses some adaptation issues, its uniform parameter distribution neglects the inherent feature hierarchy, where earlier layers, learning more general features, require more parameters than later ones. To tackle this issue, we introduce Depth Anything in Robotic Endoscopic Surgery (DARES), a novel approach that employs a new adaptation technique, Vector Low-Rank Adaptation (Vector-LoRA) on the DAM V2 to perform self-supervised monocular depth estimation in RAS scenes. To enhance learning efficiency, we introduce Vector-LoRA by integrating more parameters in earlier layers and gradually decreasing parameters in later layers. We also design a reprojection loss based on the multi-scale SSIM error to enhance depth perception by better tailoring the foundation model to the specific requirements of the surgical environment. The proposed method is validated on the SCARED dataset and demonstrates superior performance over recent state-of-the-art self-supervised monocular depth estimation techniques, achieving an improvement of 13.3% in the absolute relative error metric. The code and pre-trained weights are available at https://github.com/mobarakol/DARES.

Mismatched: Evaluating the Limits of Image Matching Approaches and Benchmarks

Three-dimensional (3D) reconstruction from two-dimensional images is an active research field in computer vision, with applications ranging from navigation and object tracking to segmentation and three-dimensional modeling. Traditionally, parametric techniques have been employed for this task. However, recent advancements have seen a shift towards learning-based methods. Given the rapid pace of research and the frequent introduction of new image matching methods, it is essential to evaluate them. In this paper, we present a comprehensive evaluation of various image matching methods using a structure-from-motion pipeline. We assess the performance of these methods on both in-domain and out-of-domain datasets, identifying key limitations in both the methods and benchmarks. We also investigate the impact of edge detection as a pre-processing step. Our analysis reveals that image matching for 3D reconstruction remains an open challenge, necessitating careful selection and tuning of models for specific scenarios, while also highlighting mismatches in how metrics currently represent method performance.

CathAction: A Benchmark for Endovascular Intervention Understanding

Real-time visual feedback from catheterization analysis is crucial for enhancing surgical safety and efficiency during endovascular interventions. However, existing datasets are often limited to specific tasks, small scale, and lack the comprehensive annotations necessary for broader endovascular intervention understanding. To tackle these limitations, we introduce CathAction, a large-scale dataset for catheterization understanding. Our CathAction dataset encompasses approximately 500,000 annotated frames for catheterization action understanding and collision detection, and 25,000 ground truth masks for catheter and guidewire segmentation. For each task, we benchmark recent related works in the field. We further discuss the challenges of endovascular intentions compared to traditional computer vision tasks and point out open research questions. We hope that CathAction will facilitate the development of endovascular intervention understanding methods that can be applied to real-world applications. The dataset is available at https://airvlab.github.io/cathdata/.

Personalizing Federated Instrument Segmentation with Visual Trait Priors in Robotic Surgery

Personalized federated learning (PFL) for surgical instrument segmentation (SIS) is a promising approach. It enables multiple clinical sites to collaboratively train a series of models in privacy, with each model tailored to the individual distribution of each site. Existing PFL methods rarely consider the personalization of multi-headed self-attention, and do not account for appearance diversity and instrument shape similarity, both inherent in surgical scenes. We thus propose PFedSIS, a novel PFL method with visual trait priors for SIS, incorporating global-personalized disentanglement (GPD), appearance-regulation personalized enhancement (APE), and shape-similarity global enhancement (SGE), to boost SIS performance in each site. GPD represents the first attempt at head-wise assignment for multi-headed self-attention personalization. To preserve the unique appearance representation of each site and gradually leverage the inter-site difference, APE introduces appearance regulation and provides customized layer-wise aggregation solutions via hypernetworks for each site's personalized parameters. The mutual shape information of instruments is maintained and shared via SGE, which enhances the cross-style shape consistency on the image level and computes the shape-similarity contribution of each site on the prediction level for updating the global parameters. PFedSIS outperforms state-of-the-art methods with +1.51% Dice, +2.11% IoU, -2.79 ASSD, -15.55 HD95 performance gains. The corresponding code and models will be released at https://github.com/wzjialang/PFedSIS.

HUP-3D: A 3D multi-view synthetic dataset for assisted-egocentric hand-ultrasound pose estimation

We present HUP-3D, a 3D multi-view multi-modal synthetic dataset for hand-ultrasound (US) probe pose estimation in the context of obstetric ultrasound. Egocentric markerless 3D joint pose estimation has potential applications in mixed reality based medical education. The ability to understand hand and probe movements programmatically opens the door to tailored guidance and mentoring applications. Our dataset consists of over 31k sets of RGB, depth and segmentation mask frames, including pose related ground truth data, with a strong emphasis on image diversity and complexity. Adopting a camera viewpoint-based sphere concept allows us to capture a variety of views and generate multiple hand grasp poses using a pre-trained network. Additionally, our approach includes a software-based image rendering concept, enhancing diversity with various hand and arm textures, lighting conditions, and background images. Furthermore, we validated our proposed dataset with state-of-the-art learning models and we obtained the lowest hand-object keypoint errors. The dataset and other details are provided with the supplementary material. The source code of our grasp generation and rendering pipeline will be made publicly available.

Think Step by Step: Chain-of-Gesture Prompting for Error Detection in Robotic Surgical Videos

Despite significant advancements in robotic systems and surgical data science, ensuring safe and optimal execution in robot-assisted minimally invasive surgery (RMIS) remains a complex challenge. Current surgical error detection methods involve two parts: identifying surgical gestures and then detecting errors within each gesture clip. These methods seldom consider the rich contextual and semantic information inherent in surgical videos, limiting their performance due to reliance on accurate gesture identification. Motivated by the chain-of-thought prompting in natural language processing, this letter presents a novel and real-time end-to-end error detection framework, Chain-of-Thought (COG) prompting, leveraging contextual information from surgical videos. This encompasses two reasoning modules designed to mimic the decision-making processes of expert surgeons. Concretely, we first design a Gestural-Visual Reasoning module, which utilizes transformer and attention architectures for gesture prompting, while the second, a Multi-Scale Temporal Reasoning module, employs a multi-stage temporal convolutional network with both slow and fast paths for temporal information extraction. We extensively validate our method on the public benchmark RMIS dataset JIGSAWS. Our method encapsulates the reasoning processes inherent to surgical activities enabling it to outperform the state-of-the-art by 4.6% in F1 score, 4.6% in Accuracy, and 5.9% in Jaccard index while processing each frame in 6.69 milliseconds on average, demonstrating the great potential of our approach in enhancing the safety and efficacy of RMIS procedures and surgical education. The code will be available.

SEDMamba: Enhancing Selective State Space Modelling with Bottleneck Mechanism and Fine-to-Coarse Temporal Fusion for Efficient Error Detection in Robot-Assisted Surgery

Automated detection of surgical errors can improve robotic-assisted surgery. Despite promising progress, existing methods still face challenges in capturing rich temporal context to establish long-term dependencies while maintaining computational efficiency. In this paper, we propose a novel hierarchical model named SEDMamba, which incorporates the selective state space model (SSM) into surgical error detection, facilitating efficient long sequence modelling with linear complexity. SEDMamba enhances selective SSM with bottleneck mechanism and fine-to-coarse temporal fusion (FCTF) to detect and temporally localize surgical errors in long videos. The bottleneck mechanism compresses and restores features within their spatial dimension, thereby reducing computational complexity. FCTF utilizes multiple dilated 1D convolutional layers to merge temporal information across diverse scale ranges, accommodating errors of varying durations. Besides, we deploy an established observational clinical human reliability assessment tool (OCHRA) to annotate the errors of suturing tasks in an open-source radical prostatectomy dataset (SAR-RARP50), constructing the first frame-level in-vivo surgical error detection dataset to support error detection in real-world scenarios. Experimental results demonstrate that our SEDMamba outperforms state-of-the-art methods with at least 1.82% AUC and 3.80% AP performance gain with significantly reduced computational complexity.

PitVQA: Image-grounded Text Embedding LLM for Visual Question Answering in Pituitary Surgery

Visual Question Answering (VQA) within the surgical domain, utilizing Large Language Models (LLMs), offers a distinct opportunity to improve intra-operative decision-making and facilitate intuitive surgeon-AI interaction. However, the development of LLMs for surgical VQA is hindered by the scarcity of diverse and extensive datasets with complex reasoning tasks. Moreover, contextual fusion of the image and text modalities remains an open research challenge due to the inherent differences between these two types of information and the complexity involved in aligning them. This paper introduces PitVQA, a novel dataset specifically designed for VQA in endonasal pituitary surgery and PitVQA-Net, an adaptation of the GPT2 with a novel image-grounded text embedding for surgical VQA. PitVQA comprises 25 procedural videos and a rich collection of question-answer pairs spanning crucial surgical aspects such as phase and step recognition, context understanding, tool detection and localization, and tool-tissue interactions. PitVQA-Net consists of a novel image-grounded text embedding that projects image and text features into a shared embedding space and GPT2 Backbone with an excitation block classification head to generate contextually relevant answers within the complex domain of endonasal pituitary surgery. Our image-grounded text embedding leverages joint embedding, cross-attention and contextual representation to understand the contextual relationship between questions and surgical images. We demonstrate the effectiveness of PitVQA-Net on both the PitVQA and the publicly available EndoVis18-VQA dataset, achieving improvements in balanced accuracy of 8% and 9% over the most recent baselines, respectively. Our code and dataset is available at https://github.com/mobarakol/PitVQA.

High-fidelity Endoscopic Image Synthesis by Utilizing Depth-guided Neural Surfaces

In surgical oncology, screening colonoscopy plays a pivotal role in providing diagnostic assistance, such as biopsy, and facilitating surgical navigation, particularly in polyp detection. Computer-assisted endoscopic surgery has recently gained attention and amalgamated various 3D computer vision techniques, including camera localization, depth estimation, surface reconstruction, etc. Neural Radiance Fields (NeRFs) and Neural Implicit Surfaces (NeuS) have emerged as promising methodologies for deriving accurate 3D surface models from sets of registered images, addressing the limitations of existing colon reconstruction approaches stemming from constrained camera movement. However, the inadequate tissue texture representation and confused scale problem in monocular colonoscopic image reconstruction still impede the progress of the final rendering results. In this paper, we introduce a novel method for colon section reconstruction by leveraging NeuS applied to endoscopic images, supplemented by a single frame of depth map. Notably, we pioneered the exploration of utilizing only one frame depth map in photorealistic reconstruction and neural rendering applications while this single depth map can be easily obtainable from other monocular depth estimation networks with an object scale. Through rigorous experimentation and validation on phantom imagery, our approach demonstrates exceptional accuracy in completely rendering colon sections, even capturing unseen portions of the surface. This breakthrough opens avenues for achieving stable and consistently scaled reconstructions, promising enhanced quality in cancer screening procedures and treatment interventions.

Measuring proximity to standard planes during fetal brain ultrasound scanning

This paper introduces a novel pipeline designed to bring ultrasound (US) plane pose estimation closer to clinical use for more effective navigation to the standard planes (SPs) in the fetal brain. We propose a semi-supervised segmentation model utilizing both labeled SPs and unlabeled 3D US volume slices. Our model enables reliable segmentation across a diverse set of fetal brain images. Furthermore, the model incorporates a classification mechanism to identify the fetal brain precisely. Our model not only filters out frames lacking the brain but also generates masks for those containing it, enhancing the relevance of plane pose regression in clinical settings. We focus on fetal brain navigation from 2D ultrasound (US) video analysis and combine this model with a US plane pose regression network to provide sensorless proximity detection to SPs and non-SPs planes; we emphasize the importance of proximity detection to SPs for guiding sonographers, offering a substantial advantage over traditional methods by allowing earlier and more precise adjustments during scanning. We demonstrate the practical applicability of our approach through validation on real fetal scan videos obtained from sonographers of varying expertise levels. Our findings demonstrate the potential of our approach to complement existing fetal US technologies and advance prenatal diagnostic practices.