Rendezvous in time: an attention-based temporal fusion approach for surgical triplet recognition

Vision techniques for anatomical structures in laparoscopic surgery: a comprehensive review

Laparoscopic surgery is the method of choice for numerous surgical procedures, while it confronts a lot of challenges. Computer vision exerts a vital role in addressing these challenges and has become a research hotspot, especially in the classification, segmentation, and target detection of abdominal anatomical structures. This study presents a comprehensive review of the last decade of research in this area. At first, a categorized overview of the core subtasks is presented regarding their relevance and applicability to real-world medical scenarios. Second, the dataset used in the experimental validation is statistically analyzed. Subsequently, the technical approaches and trends of classification, segmentation, and target detection tasks are explored in detail, highlighting their advantages, limitations, and practical implications. Additionally, evaluation methods for the three types of tasks are discussed. Finally, gaps in current research are identified. Meanwhile, the great potential for development in this area is emphasized.

Parameter-efficient framework for surgical action triplet recognition

PURPOSE

Surgical action triplet recognition is a clinically significant yet challenging task. It provides surgeons with detailed information about surgical scenarios, thereby facilitating clinical decision-making. However, the high similarity among action triplets presents a formidable obstacle to recognition. To enhance accuracy, prior methods necessitated the utilization of larger models, thereby incurring a considerable computational burden.

METHODS

We propose a novel framework known as the Lite and Mega Models (LAM). It comprises a CNN-based fully fine-tuned model (LAM-Lite) and a parameter-efficient fine-tuned model based on the foundation model using Transformer architecture (LAM-Mega). Temporal multi-label data augmentation is introduced for extracting robust class-level features.

RESULTS

Our study demonstrates that LAM outperforms prior methods across various parameter scales on the CholecT50 dataset. Using fewer tunable parameters, LAM achieves a mean average precision (mAP) of 42.1%, a 3.6% improvement over the previous state of the art.

CONCLUSION

Leveraging effective structural design and robust capabilities of the foundational model, our proposed approach successfully strikes a balance between accuracy and computational efficiency. The source code is accessible at https://github.com/Lycus99/LAM .

MT4MTL-KD: A Multi-Teacher Knowledge Distillation Framework for Triplet Recognition

The recognition of surgical triplets plays a critical role in the practical application of surgical videos. It involves the sub-tasks of recognizing instruments, verbs, and targets, while establishing precise associations between them. Existing methods face two significant challenges in triplet recognition: 1) the imbalanced class distribution of surgical triplets may lead to spurious task association learning, and 2) the feature extractors cannot reconcile local and global context modeling. To overcome these challenges, this paper presents a novel multi-teacher knowledge distillation framework for multi-task triplet learning, known as MT4MTL-KD. MT4MTL-KD leverages teacher models trained on less imbalanced sub-tasks to assist multi-task student learning for triplet recognition. Moreover, we adopt different categories of backbones for the teacher and student models, facilitating the integration of local and global context modeling. To further align the semantic knowledge between the triplet task and its sub-tasks, we propose a novel feature attention module (FAM). This module utilizes attention mechanisms to assign multi-task features to specific sub-tasks. We evaluate the performance of MT4MTL-KD on both the 5-fold cross-validation and the CholecTriplet challenge splits of the CholecT45 dataset. The experimental results consistently demonstrate the superiority of our framework over state-of-the-art methods, achieving significant improvements of up to 6.4% on the cross-validation split.

Surgical phase and instrument recognition: how to identify appropriate dataset splits

PURPOSE

Machine learning approaches can only be reliably evaluated if training, validation, and test data splits are representative and not affected by the absence of classes. Surgical workflow and instrument recognition are two tasks that are complicated in this manner, because of heavy data imbalances resulting from different length of phases and their potential erratic occurrences. Furthermore, sub-properties like instrument (co-)occurrence are usually not particularly considered when defining the split.

METHODS

We present a publicly available data visualization tool that enables interactive exploration of dataset partitions for surgical phase and instrument recognition. The application focuses on the visualization of the occurrence of phases, phase transitions, instruments, and instrument combinations across sets. Particularly, it facilitates assessment of dataset splits, especially regarding identification of sub-optimal dataset splits.

RESULTS

We performed analysis of the datasets Cholec80, CATARACTS, CaDIS, M2CAI-workflow, and M2CAI-tool using the proposed application. We were able to uncover phase transitions, individual instruments, and combinations of surgical instruments that were not represented in one of the sets. Addressing these issues, we identify possible improvements in the splits using our tool. A user study with ten participants demonstrated that the participants were able to successfully solve a selection of data exploration tasks.

CONCLUSION

In highly unbalanced class distributions, special care should be taken with respect to the selection of an appropriate dataset split because it can greatly influence the assessments of machine learning approaches. Our interactive tool allows for determination of better splits to improve current practices in the field. The live application is available at https://cardio-ai.github.io/endovis-ml/ .