From Monocular Vision to Autonomous Action: Guiding Tumor Resection via 3D Reconstruction

Surgical automation requires precise guidance and understanding of the scene. Current methods in the literature rely on bulky depth cameras to create maps of the anatomy, however this does not translate well to space-limited clinical applications. Monocular cameras are small and allow minimally invasive surgeries in tight spaces but additional processing is required to generate 3D scene understanding. We propose a 3D mapping pipeline that uses only RGB images to create segmented point clouds of the target anatomy. To ensure the most precise reconstruction, we compare different structure from motion algorithms' performance on mapping the central airway obstructions, and test the pipeline on a downstream task of tumor resection. In several metrics, including post-procedure tissue model evaluation, our pipeline performs comparably to RGB-D cameras and, in some cases, even surpasses their performance. These promising results demonstrate that automation guidance can be achieved in minimally invasive procedures with monocular cameras. This study is a step toward the complete autonomy of surgical robots.

Multi-Modal Gesture Recognition from Video and Surgical Tool Pose Information via Motion Invariants

Recognizing surgical gestures in real-time is a stepping stone towards automated activity recognition, skill assessment, intra-operative assistance, and eventually surgical automation. The current robotic surgical systems provide us with rich multi-modal data such as video and kinematics. While some recent works in multi-modal neural networks learn the relationships between vision and kinematics data, current approaches treat kinematics information as independent signals, with no underlying relation between tool-tip poses. However, instrument poses are geometrically related, and the underlying geometry can aid neural networks in learning gesture representation. Therefore, we propose combining motion invariant measures (curvature and torsion) with vision and kinematics data using a relational graph network to capture the underlying relations between different data streams. We show that gesture recognition improves when combining invariant signals with tool position, achieving 90.3\% frame-wise accuracy on the JIGSAWS suturing dataset. Our results show that motion invariant signals coupled with position are better representations of gesture motion compared to traditional position and quaternion representations. Our results highlight the need for geometric-aware modeling of kinematics for gesture recognition.

Sensorless Remote Center of Motion Misalignment Estimation

Laparoscopic surgery constrains instrument motion around a fixed pivot point at the incision into a patient to minimize tissue trauma. Surgical robots achieve this through either hardware to software-based remote center of motion (RCM) constraints. However, accurate RCM alignment is difficult due to manual trocar placement, patient motion, and tissue deformation. Misalignment between the robot's RCM point and the patient incision site can cause unsafe forces at the incision site. This paper presents a sensorless force estimation-based framework for dynamically assessing and optimizing RCM misalignment in robotic surgery. Our experiments demonstrate that misalignment exceeding 20 mm can generate large enough forces to potentially damage tissue, emphasizing the need for precise RCM positioning. For misalignment $D\geq $ 20 mm, our optimization algorithm estimates the RCM offset with an absolute error within 5 mm. Accurate RCM misalignment estimation is a step toward automated RCM misalignment compensation, enhancing safety and reducing tissue damage in robotic-assisted laparoscopic surgery.

Deformable Registration Framework for Augmented Reality-based Surgical Guidance in Head and Neck Tumor Resection

Head and neck squamous cell carcinoma (HNSCC) has one of the highest rates of recurrence cases among solid malignancies. Recurrence rates can be reduced by improving positive margins localization. Frozen section analysis (FSA) of resected specimens is the gold standard for intraoperative margin assessment. However, because of the complex 3D anatomy and the significant shrinkage of resected specimens, accurate margin relocation from specimen back onto the resection site based on FSA results remains challenging. We propose a novel deformable registration framework that uses both the pre-resection upper surface and the post-resection site of the specimen to incorporate thickness information into the registration process. The proposed method significantly improves target registration error (TRE), demonstrating enhanced adaptability to thicker specimens. In tongue specimens, the proposed framework improved TRE by up to 33% as compared to prior deformable registration. Notably, tongue specimens exhibit complex 3D anatomies and hold the highest clinical significance compared to other head and neck specimens from the buccal and skin. We analyzed distinct deformation behaviors in different specimens, highlighting the need for tailored deformation strategies. To further aid intraoperative visualization, we also integrated this framework with an augmented reality-based auto-alignment system. The combined system can accurately and automatically overlay the deformed 3D specimen mesh with positive margin annotation onto the resection site. With a pilot study of the AR guided framework involving two surgeons, the integrated system improved the surgeons' average target relocation error from 9.8 cm to 4.8 cm.

EndoPBR: Material and Lighting Estimation for Photorealistic Surgical Simulations via Physically-based Rendering

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

Gravity Compensation of the dVRK-Si Patient Side Manipulator based on Dynamic Model Identification

The da Vinci Research Kit (dVRK, also known as dVRK Classic) is an open-source teleoperated surgical robotic system whose hardware is obtained from the first generation da Vinci Surgical System (Intuitive, Sunnyvale, CA, USA). The dVRK has greatly facilitated research in robot-assisted surgery over the past decade and helped researchers address multiple major challenges in this domain. Recently, the dVRK-Si system, a new version of the dVRK which uses mechanical components from the da Vinci Si Surgical System, became available to the community. The major difference between the first generation da Vinci and the da Vinci Si is in the structural upgrade of the Patient Side Manipulator (PSM). Because of this upgrade, the gravity of the dVRK-Si PSM can no longer be ignored as in the dVRK Classic. The high gravity offset may lead to relatively low control accuracy and longer response time. In addition, although substantial progress has been made in addressing the dynamic model identification problem for the dVRK Classic, further research is required on model-based control for the dVRK-Si, due to differences in mechanical components and the demand for enhanced control performance. To address these problems, in this work, we present (1) a novel full kinematic model of the dVRK-Si PSM, and (2) a gravity compensation approach based on the dynamic model identification.

A Hybrid Model and Learning-Based Force Estimation Framework for Surgical Robots

Haptic feedback to the surgeon during robotic surgery would enable safer and more immersive surgeries but estimating tissue interaction forces at the tips of robotically controlled surgical instruments has proven challenging. Few existing surgical robots can measure interaction forces directly and the additional sensor may limit the life of instruments. We present a hybrid model and learning-based framework for force estimation for the Patient Side Manipulators (PSM) of a da Vinci Research Kit (dVRK). The model-based component identifies the dynamic parameters of the robot and estimates free-space joint torque, while the learning-based component compensates for environmental factors, such as the additional torque caused by trocar interaction between the PSM instrument and the patient's body wall. We evaluate our method in an abdominal phantom and achieve an error in force estimation of under 10% normalized root-mean-squared error. We show that by using a model-based method to perform dynamics identification, we reduce reliance on the training data covering the entire workspace. Although originally developed for the dVRK, the proposed method is a generalizable framework for other compliant surgical robots. The code is available at https://github.com/vu-maple-lab/dvrk_force_estimation.

An Effectiveness Study Across Baseline and Neural Network-based Force Estimation Methods on the da Vinci Research Kit Si System

In this study, we further investigate the robustness and generalization ability of an neural network (NN) based force estimation method, using the da Vinci Research Kit Si (dVRK-Si). To evaluate our method's performance, we compare the force estimation accuracy with several baseline methods. We conduct comparative studies between the dVRK classic and dVRK-Si systems to benchmark the effectiveness of these approaches. We conclude that the NN-based method provides comparable force estimation accuracy across the two systems, as the average root mean square error (RMSE) over the average range of force ratio is approximately 3.07% for the dVRK classic, and 5.27% for the dVRK-Si. On the dVRK-Si, the force estimation RMSEs for all the baseline methods are 2 to 4 times larger than the NN-based method in all directions. One possible reason is, we made assumptions in the baseline methods that static forces remain the same or dynamics is time-invariant. These assumptions may hold for the dVRK Classic, as it has pre-loaded weight and maintains horizontal self balance. Since the dVRK-Si configuration does not have this property, assumptions do not hold anymore, therefore the NN-based method significantly outperforms.

MeshBrush: Painting the Anatomical Mesh with Neural Stylization for Endoscopy

Style transfer is a promising approach to close the sim-to-real gap in medical endoscopy. Rendering realistic endoscopic videos by traversing pre-operative scans (such as MRI or CT) can generate realistic simulations as well as ground truth camera poses and depth maps. Although image-to-image (I2I) translation models such as CycleGAN perform well, they are unsuitable for video-to-video synthesis due to the lack of temporal consistency, resulting in artifacts between frames. We propose MeshBrush, a neural mesh stylization method to synthesize temporally consistent videos with differentiable rendering. MeshBrush uses the underlying geometry of patient imaging data while leveraging existing I2I methods. With learned per-vertex textures, the stylized mesh guarantees consistency while producing high-fidelity outputs. We demonstrate that mesh stylization is a promising approach for creating realistic simulations for downstream tasks such as training and preoperative planning. Although our method is tested and designed for ureteroscopy, its components are transferable to general endoscopic and laparoscopic procedures.

Zero-shot Prompt-based Video Encoder for Surgical Gesture Recognition

Purpose: Surgical video is an important data stream for gesture recognition. Thus, robust visual encoders for those data-streams is similarly important. Methods: Leveraging the Bridge-Prompt framework, we fine-tune a pre-trained vision-text model (CLIP) for gesture recognition in surgical videos. This can utilize extensive outside video data such as text, but also make use of label meta-data and weakly supervised contrastive losses. Results: Our experiments show that prompt-based video encoder outperforms standard encoders in surgical gesture recognition tasks. Notably, it displays strong performance in zero-shot scenarios, where gestures/tasks that were not provided during the encoder training phase are included in the prediction phase. Additionally, we measure the benefit of inclusion text descriptions in the feature extractor training schema. Conclusion: Bridge-Prompt and similar pre-trained+fine-tuned video encoder models present significant visual representation for surgical robotics, especially in gesture recognition tasks. Given the diverse range of surgical tasks (gestures), the ability of these models to zero-shot transfer without the need for any task (gesture) specific retraining makes them invaluable.