Towards Unified Surgical Skill Assessment

Surgical skills have a great influence on surgical safety and patients' well-being. Traditional assessment of surgical skills involves strenuous manual efforts, which lacks efficiency and repeatability. Therefore, we attempt to automatically predict how well the surgery is performed using the surgical video. In this paper, a unified multi-path framework for automatic surgical skill assessment is proposed, which takes care of multiple composing aspects of surgical skills, including surgical tool usage, intraoperative event pattern, and other skill proxies. The dependency relationships among these different aspects are specially modeled by a path dependency module in the framework. We conduct extensive experiments on the JIGSAWS dataset of simulated surgical tasks, and a new clinical dataset of real laparoscopic surgeries. The proposed framework achieves promising results on both datasets, with the state-of-the-art on the simulated dataset advanced from 0.71 Spearman's correlation to 0.80. It is also shown that combining multiple skill aspects yields better performance than relying on a single aspect.

Surgical Skill Assessment on In-Vivo Clinical Data via the Clearness of Operating Field

Surgical skill assessment is important for surgery training and quality control. Prior works on this task largely focus on basic surgical tasks such as suturing and knot tying performed in simulation settings. In contrast, surgical skill assessment is studied in this paper on a real clinical dataset, which consists of fifty-seven in-vivo laparoscopic surgeries and corresponding skill scores annotated by six surgeons. From analyses on this dataset, the clearness of operating field (COF) is identified as a good proxy for overall surgical skills, given its strong correlation with overall skills and high inter-annotator consistency. Then an objective and automated framework based on neural network is proposed to predict surgical skills through the proxy of COF. The neural network is jointly trained with a supervised regression loss and an unsupervised rank loss. In experiments, the proposed method achieves 0.55 Spearman's correlation with the ground truth of overall technical skill, which is even comparable with the human performance of junior surgeons.

Unsupervised Surgical Instrument Segmentation via Anchor Generation and Semantic Diffusion

Surgical instrument segmentation is a key component in developing context-aware operating rooms. Existing works on this task heavily rely on the supervision of a large amount of labeled data, which involve laborious and expensive human efforts. In contrast, a more affordable unsupervised approach is developed in this paper. To train our model, we first generate anchors as pseudo labels for instruments and background tissues respectively by fusing coarse handcrafted cues. Then a semantic diffusion loss is proposed to resolve the ambiguity in the generated anchors via the feature correlation between adjacent video frames. In the experiments on the binary instrument segmentation task of the 2017 MICCAI EndoVis Robotic Instrument Segmentation Challenge dataset, the proposed method achieves 0.71 IoU and 0.81 Dice score without using a single manual annotation, which is promising to show the potential of unsupervised learning for surgical tool segmentation.