SurgicalVLM-Agent: Towards an Interactive AI Co-Pilot for Pituitary Surgery

Image-guided surgery demands adaptive, real-time decision support, yet static AI models struggle with structured task planning and providing interactive guidance. Large vision-language models (VLMs) offer a promising solution by enabling dynamic task planning and predictive decision support. We introduce SurgicalVLM-Agent, an AI co-pilot for image-guided pituitary surgery, capable of conversation, planning, and task execution. The agent dynamically processes surgeon queries and plans the tasks such as MRI tumor segmentation, endoscope anatomy segmentation, overlaying preoperative imaging with intraoperative views, instrument tracking, and surgical visual question answering (VQA). To enable structured task planning, we develop the PitAgent dataset, a surgical context-aware dataset covering segmentation, overlaying, instrument localization, tool tracking, tool-tissue interactions, phase identification, and surgical activity recognition. Additionally, we propose FFT-GaLore, a fast Fourier transform (FFT)-based gradient projection technique for efficient low-rank adaptation, optimizing fine-tuning for LLaMA 3.2 in surgical environments. We validate SurgicalVLM-Agent by assessing task planning and prompt generation on our PitAgent dataset and evaluating zero-shot VQA using a public pituitary dataset. Results demonstrate state-of-the-art performance in task planning and query interpretation, with highly semantically meaningful VQA responses, advancing AI-driven surgical assistance.

Endo-FASt3r: Endoscopic Foundation model Adaptation for Structure from motion

Accurate depth and camera pose estimation is essential for achieving high-quality 3D visualisations in robotic-assisted surgery. Despite recent advancements in foundation model adaptation to monocular depth estimation of endoscopic scenes via self-supervised learning (SSL), no prior work has explored their use for pose estimation. These methods rely on low rank-based adaptation approaches, which constrain model updates to a low-rank space. We propose Endo-FASt3r, the first monocular SSL depth and pose estimation framework that uses foundation models for both tasks. We extend the Reloc3r relative pose estimation foundation model by designing Reloc3rX, introducing modifications necessary for convergence in SSL. We also present DoMoRA, a novel adaptation technique that enables higher-rank updates and faster convergence. Experiments on the SCARED dataset show that Endo-FASt3r achieves a substantial $10\%$ improvement in pose estimation and a $2\%$ improvement in depth estimation over prior work. Similar performance gains on the Hamlyn and StereoMIS datasets reinforce the generalisability of Endo-FASt3r across different datasets.

PitVQA++: Vector Matrix-Low-Rank Adaptation for Open-Ended Visual Question Answering in Pituitary Surgery

Vision-Language Models (VLMs) in visual question answering (VQA) offer a unique opportunity to enhance intra-operative decision-making, promote intuitive interactions, and significantly advancing surgical education. However, the development of VLMs for surgical VQA is challenging due to limited datasets and the risk of overfitting and catastrophic forgetting during full fine-tuning of pretrained weights. While parameter-efficient techniques like Low-Rank Adaptation (LoRA) and Matrix of Rank Adaptation (MoRA) address adaptation challenges, their uniform parameter distribution overlooks the feature hierarchy in deep networks, where earlier layers, that learn general features, require more parameters than later ones. This work introduces PitVQA++ with an open-ended PitVQA dataset and vector matrix-low-rank adaptation (Vector-MoLoRA), an innovative VLM fine-tuning approach for adapting GPT-2 to pituitary surgery. Open-Ended PitVQA comprises around 101,803 frames from 25 procedural videos with 745,972 question-answer sentence pairs, covering key surgical elements such as phase and step recognition, context understanding, tool detection, localization, and interactions recognition. Vector-MoLoRA incorporates the principles of LoRA and MoRA to develop a matrix-low-rank adaptation strategy that employs vector ranking to allocate more parameters to earlier layers, gradually reducing them in the later layers. Our approach, validated on the Open-Ended PitVQA and EndoVis18-VQA datasets, effectively mitigates catastrophic forgetting while significantly enhancing performance over recent baselines. Furthermore, our risk-coverage analysis highlights its enhanced reliability and trustworthiness in handling uncertain predictions. Our source code and dataset is available at~\url{https://github.com/HRL-Mike/PitVQA-Plus}.

SHADeS: Self-supervised Monocular Depth Estimation Through Non-Lambertian Image Decomposition

Purpose: Visual 3D scene reconstruction can support colonoscopy navigation. It can help in recognising which portions of the colon have been visualised and characterising the size and shape of polyps. This is still a very challenging problem due to complex illumination variations, including abundant specular reflections. We investigate how to effectively decouple light and depth in this problem. Methods: We introduce a self-supervised model that simultaneously characterises the shape and lighting of the visualised colonoscopy scene. Our model estimates shading, albedo, depth, and specularities (SHADeS) from single images. Unlike previous approaches (IID), we use a non-Lambertian model that treats specular reflections as a separate light component. The implementation of our method is available at https://github.com/RemaDaher/SHADeS. Results: We demonstrate on real colonoscopy images (Hyper Kvasir) that previous models for light decomposition (IID) and depth estimation (MonoVIT, ModoDepth2) are negatively affected by specularities. In contrast, SHADeS can simultaneously produce light decomposition and depth maps that are robust to specular regions. We also perform a quantitative comparison on phantom data (C3VD) where we further demonstrate the robustness of our model. Conclusion: Modelling specular reflections improves depth estimation in colonoscopy. We propose an effective self-supervised approach that uses this insight to jointly estimate light decomposition and depth. Light decomposition has the potential to help with other problems, such as place recognition within the colon.

SegCol Challenge: Semantic Segmentation for Tools and Fold Edges in Colonoscopy data

Colorectal cancer (CRC) remains a leading cause of cancer-related deaths worldwide, with polyp removal being an effective early screening method. However, navigating the colon for thorough polyp detection poses significant challenges. To advance camera navigation in colonoscopy, we propose the Semantic Segmentation for Tools and Fold Edges in Colonoscopy (SegCol) Challenge. This challenge introduces a dataset from the EndoMapper repository, featuring manually annotated, pixel-level semantic labels for colon folds and endoscopic tools across selected frames from 96 colonoscopy videos. By providing fold edges as anatomical landmarks and depth discontinuity information from both fold and tool labels, the dataset is aimed to improve depth perception and localization methods. Hosted as part of the Endovis Challenge at MICCAI 2024, SegCol aims to drive innovation in colonoscopy navigation systems. Details are available at https://www.synapse.org/Synapse:syn54124209/wiki/626563, and code resources at https://github.com/surgical-vision/segcol_challenge .

Dynamic Obstacle Avoidance of Unmanned Surface Vehicles in Maritime Environments Using Gaussian Processes Based Motion Planning

During recent years, unmanned surface vehicles are extensively utilised in a variety of maritime applications such as the exploration of unknown areas, autonomous transportation, offshore patrol and others. In such maritime applications, unmanned surface vehicles executing relevant missions that might collide with potential static obstacles such as islands and reefs and dynamic obstacles such as other moving unmanned surface vehicles. To successfully accomplish these missions, motion planning algorithms that can generate smooth and collision-free trajectories to avoid both these static and dynamic obstacles in an efficient manner are essential. In this article, we propose a novel motion planning algorithm named the Dynamic Gaussian process motion planner 2, which successfully extends the application scope of the Gaussian process motion planner 2 into complex and dynamic environments with both static and dynamic obstacles. First, we introduce an approach to generate safe areas for dynamic obstacles using modified multivariate Gaussian distributions. Second, we introduce an approach to integrate real-time status information of dynamic obstacles into the modified multivariate Gaussian distributions. Therefore, the multivariate Gaussian distributions with real-time statuses of dynamic obstacles can be innovatively added into the optimisation process of factor graph to generate an optimised trajectory. The proposed Dynamic Gaussian process motion planner 2 algorithm has been validated in a series of benchmark simulations in the Matrix laboratory and a dynamic obstacle avoidance mission in a high-fidelity maritime environment in the Robotic operating system to demonstrate its functionality and practicability.

RRT-GPMP2: A Motion Planner for Mobile Robots in Complex Maze Environments

With the development of science and technology, mobile robots are playing a significant important role in the new round of world revolution. Further, mobile robots might assist or replace human beings in a great number of areas. To increase the degree of automation for mobile robots, advanced motion planners need to be integrated into them to cope with various environments. Complex maze environments are common in the potential application scenarios of different mobile robots. This article proposes a novel motion planner named the rapidly exploring random tree based Gaussian process motion planner 2, which aims to tackle the motion planning problem for mobile robots in complex maze environments. To be more specific, the proposed motion planner successfully combines the advantages of a trajectory optimisation motion planning algorithm named the Gaussian process motion planner 2 and a sampling-based motion planning algorithm named the rapidly exploring random tree. To validate the performance and practicability of the proposed motion planner, we have tested it in several simulations in the Matrix laboratory and applied it on a marine mobile robot in a virtual scenario in the Robotic operating system.

NCDD: Nearest Centroid Distance Deficit for Out-Of-Distribution Detection in Gastrointestinal Vision

The integration of deep learning tools in gastrointestinal vision holds the potential for significant advancements in diagnosis, treatment, and overall patient care. A major challenge, however, is these tools' tendency to make overconfident predictions, even when encountering unseen or newly emerging disease patterns, undermining their reliability. We address this critical issue of reliability by framing it as an out-of-distribution (OOD) detection problem, where previously unseen and emerging diseases are identified as OOD examples. However, gastrointestinal images pose a unique challenge due to the overlapping feature representations between in- Distribution (ID) and OOD examples. Existing approaches often overlook this characteristic, as they are primarily developed for natural image datasets, where feature distinctions are more apparent. Despite the overlap, we hypothesize that the features of an in-distribution example will cluster closer to the centroids of their ground truth class, resulting in a shorter distance to the nearest centroid. In contrast, OOD examples maintain an equal distance from all class centroids. Based on this observation, we propose a novel nearest-centroid distance deficit (NCCD) score in the feature space for gastrointestinal OOD detection. Evaluations across multiple deep learning architectures and two publicly available benchmarks, Kvasir2 and Gastrovision, demonstrate the effectiveness of our approach compared to several state-of-the-art methods. The code and implementation details are publicly available at: https://github.com/bhattarailab/NCDD

RGB to Hyperspectral: Spectral Reconstruction for Enhanced Surgical Imaging

This study investigates the reconstruction of hyperspectral signatures from RGB data to enhance surgical imaging, utilizing the publicly available HeiPorSPECTRAL dataset from porcine surgery and an in-house neurosurgery dataset. Various architectures based on convolutional neural networks (CNNs) and transformer models are evaluated using comprehensive metrics. Transformer models exhibit superior performance in terms of RMSE, SAM, PSNR and SSIM by effectively integrating spatial information to predict accurate spectral profiles, encompassing both visible and extended spectral ranges. Qualitative assessments demonstrate the capability to predict spectral profiles critical for informed surgical decision-making during procedures. Challenges associated with capturing both the visible and extended hyperspectral ranges are highlighted using the MAE, emphasizing the complexities involved. The findings open up the new research direction of hyperspectral reconstruction for surgical applications and clinical use cases in real-time surgical environments.

Robotic Arm Platform for Multi-View Image Acquisition and 3D Reconstruction in Minimally Invasive Surgery

Minimally invasive surgery (MIS) offers significant benefits such as reduced recovery time and minimised patient trauma, but poses challenges in visibility and access, making accurate 3D reconstruction a significant tool in surgical planning and navigation. This work introduces a robotic arm platform for efficient multi-view image acquisition and precise 3D reconstruction in MIS settings. We adapted a laparoscope to a robotic arm and captured ex-vivo images of several ovine organs across varying lighting conditions (operating room and laparoscopic) and trajectories (spherical and laparoscopic). We employed recently released learning-based feature matchers combined with COLMAP to produce our reconstructions. The reconstructions were evaluated against high-precision laser scans for quantitative evaluation. Our results show that whilst reconstructions suffer most under realistic MIS lighting and trajectory, many versions of our pipeline achieve close to sub-millimetre accuracy with an average of 1.05 mm Root Mean Squared Error and 0.82 mm Chamfer distance. Our best reconstruction results occur with operating room lighting and spherical trajectories. Our robotic platform provides a tool for controlled, repeatable multi-view data acquisition for 3D generation in MIS environments which we hope leads to new datasets for training learning-based models.