ASI-Seg: Audio-Driven Surgical Instrument Segmentation with Surgeon Intention Understanding

Surgical instrument segmentation is crucial in surgical scene understanding, thereby facilitating surgical safety. Existing algorithms directly detected all instruments of pre-defined categories in the input image, lacking the capability to segment specific instruments according to the surgeon's intention. During different stages of surgery, surgeons exhibit varying preferences and focus toward different surgical instruments. Therefore, an instrument segmentation algorithm that adheres to the surgeon's intention can minimize distractions from irrelevant instruments and assist surgeons to a great extent. The recent Segment Anything Model (SAM) reveals the capability to segment objects following prompts, but the manual annotations for prompts are impractical during the surgery. To address these limitations in operating rooms, we propose an audio-driven surgical instrument segmentation framework, named ASI-Seg, to accurately segment the required surgical instruments by parsing the audio commands of surgeons. Specifically, we propose an intention-oriented multimodal fusion to interpret the segmentation intention from audio commands and retrieve relevant instrument details to facilitate segmentation. Moreover, to guide our ASI-Seg segment of the required surgical instruments, we devise a contrastive learning prompt encoder to effectively distinguish the required instruments from the irrelevant ones. Therefore, our ASI-Seg promotes the workflow in the operating rooms, thereby providing targeted support and reducing the cognitive load on surgeons. Extensive experiments are performed to validate the ASI-Seg framework, which reveals remarkable advantages over classical state-of-the-art and medical SAMs in both semantic segmentation and intention-oriented segmentation. The source code is available at https://github.com/Zonmgin-Zhang/ASI-Seg.

VS-Assistant: Versatile Surgery Assistant on the Demand of Surgeons

The surgical intervention is crucial to patient healthcare, and many studies have developed advanced algorithms to provide understanding and decision-making assistance for surgeons. Despite great progress, these algorithms are developed for a single specific task and scenario, and in practice require the manual combination of different functions, thus limiting the applicability. Thus, an intelligent and versatile surgical assistant is expected to accurately understand the surgeon's intentions and accordingly conduct the specific tasks to support the surgical process. In this work, by leveraging advanced multimodal large language models (MLLMs), we propose a Versatile Surgery Assistant (VS-Assistant) that can accurately understand the surgeon's intention and complete a series of surgical understanding tasks, e.g., surgical scene analysis, surgical instrument detection, and segmentation on demand. Specifically, to achieve superior surgical multimodal understanding, we devise a mixture of projectors (MOP) module to align the surgical MLLM in VS-Assistant to balance the natural and surgical knowledge. Moreover, we devise a surgical Function-Calling Tuning strategy to enable the VS-Assistant to understand surgical intentions, and thus make a series of surgical function calls on demand to meet the needs of the surgeons. Extensive experiments on neurosurgery data confirm that our VS-Assistant can understand the surgeon's intention more accurately than the existing MLLM, resulting in overwhelming performance in textual analysis and visual tasks. Source code and models will be made public.

SurgPLAN: Surgical Phase Localization Network for Phase Recognition

Surgical phase recognition is crucial to providing surgery understanding in smart operating rooms. Despite great progress in automatic surgical phase recognition, most existing methods are still restricted by two problems. First, these methods cannot capture discriminative visual features for each frame and motion information with simple 2D networks. Second, the frame-by-frame recognition paradigm degrades the performance due to unstable predictions within each phase, termed as phase shaking. To address these two challenges, we propose a Surgical Phase LocAlization Network, named SurgPLAN, to facilitate a more accurate and stable surgical phase recognition with the principle of temporal detection. Specifically, we first devise a Pyramid SlowFast (PSF) architecture to serve as the visual backbone to capture multi-scale spatial and temporal features by two branches with different frame sampling rates. Moreover, we propose a Temporal Phase Localization (TPL) module to generate the phase prediction based on temporal region proposals, which ensures accurate and consistent predictions within each surgical phase. Extensive experiments confirm the significant advantages of our SurgPLAN over frame-by-frame approaches in terms of both accuracy and stability.