CoPESD: A Multi-Level Surgical Motion Dataset for Training Large Vision-Language Models to Co-Pilot Endoscopic Submucosal Dissection

submucosal dissection (ESD) enables rapid resection of large lesions, minimizing recurrence rates and improving long-term overall survival. Despite these advantages, ESD is technically challenging and carries high risks of complications, necessitating skilled surgeons and precise instruments. Recent advancements in Large Visual-Language Models (LVLMs) offer promising decision support and predictive planning capabilities for robotic systems, which can augment the accuracy of ESD and reduce procedural risks. However, existing datasets for multi-level fine-grained ESD surgical motion understanding are scarce and lack detailed annotations. In this paper, we design a hierarchical decomposition of ESD motion granularity and introduce a multi-level surgical motion dataset (CoPESD) for training LVLMs as the robotic \textbf{Co}-\textbf{P}ilot of \textbf{E}ndoscopic \textbf{S}ubmucosal \textbf{D}issection. CoPESD includes 17,679 images with 32,699 bounding boxes and 88,395 multi-level motions, from over 35 hours of ESD videos for both robot-assisted and conventional surgeries. CoPESD enables granular analysis of ESD motions, focusing on the complex task of submucosal dissection. Extensive experiments on the LVLMs demonstrate the effectiveness of CoPESD in training LVLMs to predict following surgical robotic motions. As the first multimodal ESD motion dataset, CoPESD supports advanced research in ESD instruction-following and surgical automation. The dataset is available at \href{https://github.com/gkw0010/CoPESD}{https://github.com/gkw0010/CoPESD.}}

LighTDiff: Surgical Endoscopic Image Low-Light Enhancement with T-Diffusion

Advances in endoscopy use in surgeries face challenges like inadequate lighting. Deep learning, notably the Denoising Diffusion Probabilistic Model (DDPM), holds promise for low-light image enhancement in the medical field. However, DDPMs are computationally demanding and slow, limiting their practical medical applications. To bridge this gap, we propose a lightweight DDPM, dubbed LighTDiff. It adopts a T-shape model architecture to capture global structural information using low-resolution images and gradually recover the details in subsequent denoising steps. We further prone the model to significantly reduce the model size while retaining performance. While discarding certain downsampling operations to save parameters leads to instability and low efficiency in convergence during the training, we introduce a Temporal Light Unit (TLU), a plug-and-play module, for more stable training and better performance. TLU associates time steps with denoised image features, establishing temporal dependencies of the denoising steps and improving denoising outcomes. Moreover, while recovering images using the diffusion model, potential spectral shifts were noted. We further introduce a Chroma Balancer (CB) to mitigate this issue. Our LighTDiff outperforms many competitive LLIE methods with exceptional computational efficiency.

Adapting SAM for Surgical Instrument Tracking and Segmentation in Endoscopic Submucosal Dissection Videos

The precise tracking and segmentation of surgical instruments have led to a remarkable enhancement in the efficiency of surgical procedures. However, the challenge lies in achieving accurate segmentation of surgical instruments while minimizing the need for manual annotation and reducing the time required for the segmentation process. To tackle this, we propose a novel framework for surgical instrument segmentation and tracking. Specifically, with a tiny subset of frames for segmentation, we ensure accurate segmentation across the entire surgical video. Our method adopts a two-stage approach to efficiently segment videos. Initially, we utilize the Segment-Anything (SAM) model, which has been fine-tuned using the Low-Rank Adaptation (LoRA) on the EndoVis17 Dataset. The fine-tuned SAM model is applied to segment the initial frames of the video accurately. Subsequently, we deploy the XMem++ tracking algorithm to follow the annotated frames, thereby facilitating the segmentation of the entire video sequence. This workflow enables us to precisely segment and track objects within the video. Through extensive evaluation of the in-distribution dataset (EndoVis17) and the out-of-distribution datasets (EndoVis18 \& the endoscopic submucosal dissection surgery (ESD) dataset), our framework demonstrates exceptional accuracy and robustness, thus showcasing its potential to advance the automated robotic-assisted surgery.

OSSAR: Towards Open-Set Surgical Activity Recognition in Robot-assisted Surgery

In the realm of automated robotic surgery and computer-assisted interventions, understanding robotic surgical activities stands paramount. Existing algorithms dedicated to surgical activity recognition predominantly cater to pre-defined closed-set paradigms, ignoring the challenges of real-world open-set scenarios. Such algorithms often falter in the presence of test samples originating from classes unseen during training phases. To tackle this problem, we introduce an innovative Open-Set Surgical Activity Recognition (OSSAR) framework. Our solution leverages the hyperspherical reciprocal point strategy to enhance the distinction between known and unknown classes in the feature space. Additionally, we address the issue of over-confidence in the closed set by refining model calibration, avoiding misclassification of unknown classes as known ones. To support our assertions, we establish an open-set surgical activity benchmark utilizing the public JIGSAWS dataset. Besides, we also collect a novel dataset on endoscopic submucosal dissection for surgical activity tasks. Extensive comparisons and ablation experiments on these datasets demonstrate the significant outperformance of our method over existing state-of-the-art approaches. Our proposed solution can effectively address the challenges of real-world surgical scenarios. Our code is publicly accessible at https://github.com/longbai1006/OSSAR.

A Miniature 3-DoF Flexible Parallel Robotic Wrist Using NiTi Wires for Gastrointestinal Endoscopic Surgery

Gastrointestinal endoscopic surgery (GES) has high requirements for instruments' size and distal dexterity, because of the narrow endoscopic channel and long, tortuous human gastrointestinal tract. This paper utilized Nickel-Titanium (NiTi) wires to develop a miniature 3-DoF (pitch-yaw-translation) flexible parallel robotic wrist (FPRW). Additionally, we assembled an electric knife on the wrist's connection interface and then teleoperated it to perform an endoscopic submucosal dissection (ESD) on porcine stomachs. The effective performance in each ESD workflow proves that the designed FPRW has sufficient workspace, high distal dexterity, and high positioning accuracy.