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.
The University of Texas at Austin（德克萨斯大学奥斯汀分校）；UT Southwestern Medical Center（德克萨斯大学西南医学中心）
Surgical activity recognition and prediction can help provide important context in many Robot-Assisted Surgery (RAS) applications, for example, surgical progress monitoring and estimation, surgical skill evaluation, and shared control strategies during teleoperation. Transformer models were first developed for Natural Language Processing (NLP) to model word sequences and soon the method gained popularity for general sequence modeling tasks. In this paper, we propose the novel use of a Transformer model for three tasks: gesture recognition, gesture prediction, and trajectory prediction during R…
Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS)（惠康/工程与物理科学研究委员会介入与外科科学中心（WEISS））；University College London（伦敦大学学院）
Objective: Surgical activity recognition is a fundamental step in computer-assisted interventions. This paper reviews the state-of-the-art in methods for automatic recognition of fine-grained gestures in robotic surgery focusing on recent data-driven approaches and outlines the open questions and future research directions. Methods: An article search was performed on 5 bibliographic databases with the following search terms: robotic, robot-assisted, JIGSAWS, surgery, surgical, gesture, fine-grained, surgeme, action, trajectory, segmentation, recognition, parsing. Selected articles were classif…
Think Step by Step: Chain-of-Gesture Prompting for Error Detection in Robotic Surgical Videos
Tsinghua University（清华大学）；National University of Singapore（新加坡国立大学）；University College London（伦敦大学学院）；Wellcome/EPSRC Centre for Interventional and Surgical Sciences（Wellcome/EPSRC介入与外科科学中心）
California Institute of Technology（加州理工学院）；University of Southern California（南加州大学）
Surgery is a high-stakes domain where surgeons must navigate critical anatomical structures and actively avoid potential complications while achieving the main task at hand. Such surgical activity has been shown to affect long-term patient outcomes. To better understand this relationship, whose mechanics remain unknown for the majority of surgical procedures, we hypothesize that the core elements of surgery must first be quantified in a reliable, objective, and scalable manner. We believe this is a prerequisite for the provision of surgical feedback and modulation of surgeon performance in pur…
Our previous work classified a taxonomy of suturing gestures during a vesicourethral anastomosis of robotic radical prostatectomy in association with tissue tears and patient outcomes. Herein, we train deep-learning based computer vision (CV) to automate the identification and classification of suturing gestures for needle driving attempts. Using two independent raters, we manually annotated live suturing video clips to label timepoints and gestures. Identification (2395 videos) and classification (511 videos) datasets were compiled to train CV models to produce two- and five-class label predi…
Despite significant developments in the design of surgical robots and automated techniques for objective evaluation of surgical skills, there are still challenges in ensuring safety in robot-assisted minimally-invasive surgery (RMIS). This paper presents a runtime monitoring system for the detection of executional errors during surgical tasks through the analysis of kinematic data. The proposed system incorporates dual Siamese neural networks and knowledge of surgical context, including surgical tasks and gestures, their distributional similarities, and common error modes, to learn the differe…
Isfahan University of Technology（伊斯法罕理工大学）；University of Michigan（密歇根大学）
Hand gesture is one of the most important means of touchless communication between human and machines. There is a great interest for commanding electronic equipment in surgery rooms by hand gesture for reducing the time of surgery and the potential for infection. There are challenges in implementation of a hand gesture recognition system. It has to fulfill requirements such as high accuracy and fast response. In this paper we introduce a system of hand gesture recognition based on a deep learning approach. Deep learning is known as an accurate detection model, but its high complexity prevents …
The University of Texas at Dallas（得克萨斯大学达拉斯分校）；UT Southwestern Medical Center（得克萨斯大学西南医学中心）
With the advent of robot-assisted surgery, the role of data-driven approaches to integrate statistics and machine learning is growing rapidly with prominent interests in objective surgical skill assessment. However, most existing work requires translating robot motion kinematics into intermediate features or gesture segments that are expensive to extract, lack efficiency, and require significant domain-specific knowledge. We propose an analytical deep learning framework for skill assessment in surgical training. A deep convolutional neural network is implemented to map multivariate time series…
Manual labeling of gestures in robot-assisted surgery is labor intensive, prone to errors, and requires expertise or training. We propose a method for automated and explainable generation of gesture transcripts that leverages the abundance of data for image segmentation. Surgical context is detected using segmentation masks by examining the distances and intersections between the tools and objects. Next, context labels are translated into gesture transcripts using knowledge-based Finite State Machine (FSM) and data-driven Long Short Term Memory (LSTM) models. We evaluate the performance of eac…
Minimally invasive surgery mainly consists of a series of sub-tasks, which can be decomposed into basic gestures or contexts. As a prerequisite of autonomic operation, surgical gesture recognition can assist motion planning and decision-making, and build up context-aware knowledge to improve the surgical robot control quality. In this work, we aim to develop an effective surgical gesture recognition approach with an explainable feature extraction process. A Bidirectional Multi-Layer independently RNN (BML-indRNN) model is proposed in this paper, while spatial feature extraction is implemented …
The Chinese University of Hong Kong（香港中文大学）；The Hong Kong Polytechnic University（香港理工大学）
Automated surgical gesture recognition is of great importance in robot-assisted minimally invasive surgery. However, existing methods assume that training and testing data are from the same domain, which suffers from severe performance degradation when a domain gap exists, such as the simulator and real robot. In this paper, we propose a novel unsupervised domain adaptation framework which can simultaneously transfer multi-modality knowledge, i.e., both kinematic and visual data, from simulator to real robot. It remedies the domain gap with enhanced transferable features by using temporal cues…
Recognition of surgical gesture is crucial for surgical skill assessment and efficient surgery training. Prior works on this task are based on either variant graphical models such as HMMs and CRFs, or deep learning models such as Recurrent Neural Networks and Temporal Convolutional Networks. Most of the current approaches usually suffer from over-segmentation and therefore low segment-level edit scores. In contrast, we present an essentially different methodology by modeling the task as a sequential decision-making process. An intelligent agent is trained using reinforcement learning with hier…
Monash University（莫纳什大学）；University of Haute-Alsace（上阿尔萨斯大学）
Over the past one hundred years, the classic teaching methodology of "see one, do one, teach one" has governed the surgical education systems worldwide. With the advent of Operation Room 2.0, recording video, kinematic and many other types of data during the surgery became an easy task, thus allowing artificial intelligence systems to be deployed and used in surgical and medical practice. Recently, surgical videos has been shown to provide a structure for peer coaching enabling novice trainees to learn from experienced surgeons by replaying those videos. However, the high inter-operator variab…
Intuitive Surgical Inc.（直觉外科公司）；California Institute of Technology（加州理工学院）
This paper presents a technique to concurrently and jointly predict the future trajectories of surgical instruments and the future state(s) of surgical subtasks in robot-assisted surgeries (RAS) using multiple input sources. Such predictions are a necessary first step towards shared control and supervised autonomy of surgical subtasks. Minute-long surgical subtasks, such as suturing or ultrasound scanning, often have distinguishable tool kinematics and visual features, and can be described as a series of fine-grained states with transition schematics. We propose daVinciNet - an end-to-end dual…
Purpose: This paper focuses on an automated analysis of surgical motion profiles for objective skill assessment and task recognition in robot-assisted surgery. Existing techniques heavily rely on conventional statistic measures or shallow modelings based on hand-engineered features and gesture segmentation. Such developments require significant expert knowledge, are prone to errors, and are less efficient in online adaptive training systems. Methods: In this work, we present an efficient analytic framework with a parallel deep learning architecture, SATR-DL, to assess trainee expertise and rec…
SUNY Buffalo（纽约州立大学布法罗分校）；Roswell Park Cancer Institute（罗斯韦尔公园癌症研究所）；University of Michigan（密歇根大学）
We propose a novel multi-modal and multi-task architecture for simultaneous low level gesture and surgical task classification in Robot Assisted Surgery (RAS) videos.Our end-to-end architecture is based on the principles of a long short-term memory network (LSTM) that jointly learns temporal dynamics on rich representations of visual and motion features, while simultaneously classifying activities of low-level gestures and surgical tasks. Our experimental results show that our approach is superior compared to an ar- chitecture that classifies the gestures and surgical tasks separately on visua…
Technion – Israel Institute of Technology（以色列理工学院）；Stanford University（斯坦福大学）
In recent times there is a growing development of video based applications for surgical purposes. Part of these applications can work offline after the end of the procedure, other applications must react immediately. However, there are cases where the response should be done during the procedure but some delay is acceptable. In the literature, the online-offline performance gap is known. Our goal in this study was to learn the performance-delay trade-off and design an MS-TCN++-based algorithm that can utilize this trade-off. To this aim, we used our open surgery simulation data-set containing …
The use of hand gestures can be a useful tool for many applications in the human-computer interaction community. In a broad range of areas hand gesture techniques can be applied specifically in sign language recognition, robotic surgery, etc. In the process of hand gesture recognition, proper detection, and tracking of the moving hand become challenging due to the varied shape and size of the hand. Here the objective is to track the movement of the hand irrespective of the shape, size, and color of the hand. And, for this, a motion template guided by optical flow (OFMT) is proposed. OFMT is a …
The Chinese University of Hong Kong（香港中文大学）；T Stone Robotics Institute（T Stone机器人研究所）
Predicting future frames for robotic surgical video is an interesting, important yet extremely challenging problem, given that the operative tasks may have complex dynamics. Existing approaches on future prediction of natural videos were based on either deterministic models or stochastic models, including deep recurrent neural networks, optical flow, and latent space modeling. However, the potential in predicting meaningful movements of robots with dual arms in surgical scenarios has not been tapped so far, which is typically more challenging than forecasting independent motions of one arm rob…
University of Science and Technology of China（中国科学技术大学）；Chinese PLA General Hospital（中国人民解放军总医院）
Autonomous robotic surgery has advanced significantly based on analysis of visual and temporal cues in surgical workflow, but relational cues from domain knowledge remain under investigation. Complex relations in surgical annotations can be divided into intra- and inter-relations, both valuable to autonomous systems to comprehend surgical workflows. Intra- and inter-relations describe the relevance of various categories within a particular annotation type and the relevance of different annotation types, respectively. This paper aims to systematically investigate the importance of relational cu…
Georgia Institute of Technology（佐治亚理工学院）；Twentieth Century Fox（二十世纪福克斯公司）；Starfleet Academy（星际舰队学院）；Tyrell Inc.（泰瑞尔公司）
Video understanding of robot-assisted surgery (RAS) videos is an active research area. Modeling the gestures and skill level of surgeons presents an interesting problem. The insights drawn may be applied in effective skill acquisition, objective skill assessment, real-time feedback, and human-robot collaborative surgeries. We propose a solution to the tool detection and localization open problem in RAS video understanding, using a strictly computer vision approach and the recent advances of deep learning. We propose an architecture using multimodal convolutional neural networks for fast detect…
Decoding the Surgical Scene: A Scoping Review of Scene Graphs in Surgery
School of Computation, Information and Technology, Technical University of Munich（计算信息学院，慕尼黑技术大学）；Klinik und Poliklinik für Augenheilkunde, TUM University Hospital（眼科诊所，TUM大学医院）；Computer Aided Medical Procedures, Technical University of Munich（医学辅助程序，慕尼黑技术大学）；Department of Biomedical Engineering, University of Alberta（生物医学工程系，阿尔伯塔大学）
Argonne National Laboratory（阿贡国家实验室）；University of Illinois at Chicago（伊利诺伊大学芝加哥分校）
Robot-assisted minimally invasive surgery is improving surgeon performance and patient outcomes. This innovation is also turning what has been a subjective practice into motion sequences that can be precisely measured. A growing number of studies have used machine learning to analyze video and kinematic data captured from surgical robots. In these studies, models are typically trained on benchmark datasets for representative surgical tasks to assess surgeon skill levels. While they have shown that novices and experts can be accurately classified, it is not clear whether machine learning can se…
