
arXiv: 2504.18954
Abstract Purpose Automated surgical phase recognition (SPR) uses artificial intelligence (AI) to segment the surgical workflow into its key events, functioning as a building block for efficient video review, surgical education as well as skill assessment. Previous research has focused on short and linear surgical procedures and has not explored if temporal context influences experts’ ability to better classify surgical phases. This research addresses these gaps, focusing on robot-assisted partial nephrectomy (RAPN) as a highly nonlinear procedure. Methods Urologists of varying expertise were grouped and tasked to indicate the surgical phase for RAPN on both single frames and video snippets using a custom-made web platform. Participants reported their confidence levels and the visual landmarks used in their decision-making. AI architectures without and with temporal context as trained and benchmarked on the Cholec80 data set were subsequently trained on this RAPN data set. Results Video snippets and presence of specific visual landmarks improved phase classification accuracy across all groups. Surgeons displayed high confidence in their classifications and outperformed novices, who struggled discriminating phases. The performance of the AI models is comparable to the surgeons in the survey, with improvements when temporal context was incorporated in both cases. Conclusion SPR is an inherently complex task for expert surgeons and computer vision, where both perform equally well when given the same context. Performance increases when temporal information is provided. Surgical tools and organs form the key landmarks for human interpretation and are expected to shape the future of automated SPR.
Grant number HBC.2020.2252 (Pieter De Backer), FOS: Computer and information sciences, Technology, Surgical data science, Computer Science - Artificial Intelligence, Computer Vision and Pattern Recognition (cs.CV), Video Recording, Computer Science - Computer Vision and Pattern Recognition, Nephrectomy, RAPN, Workflow, Engineering, Robotic Surgical Procedures, Artificial Intelligence, Surgical phase recognition, FOS: Electrical engineering, electronic engineering, information engineering, Humans, Grant number HBC.2023.0156 (Marco Mezzina), Engineering, Biomedical, Surgeons, Science & Technology, Radiology, Nuclear Medicine & Medical Imaging, Image and Video Processing (eess.IV), 3202 Clinical sciences, Baekeland grant of Flanders Innovation & Entrepreneurship (VLAIO), Deep learning, 1103 Clinical Sciences, Electrical Engineering and Systems Science - Image and Video Processing, Nuclear Medicine & Medical Imaging, 4603 Computer vision and multimedia computation, Artificial Intelligence (cs.AI), Surgery, Original Article, Clinical Competence, Life Sciences & Biomedicine
Grant number HBC.2020.2252 (Pieter De Backer), FOS: Computer and information sciences, Technology, Surgical data science, Computer Science - Artificial Intelligence, Computer Vision and Pattern Recognition (cs.CV), Video Recording, Computer Science - Computer Vision and Pattern Recognition, Nephrectomy, RAPN, Workflow, Engineering, Robotic Surgical Procedures, Artificial Intelligence, Surgical phase recognition, FOS: Electrical engineering, electronic engineering, information engineering, Humans, Grant number HBC.2023.0156 (Marco Mezzina), Engineering, Biomedical, Surgeons, Science & Technology, Radiology, Nuclear Medicine & Medical Imaging, Image and Video Processing (eess.IV), 3202 Clinical sciences, Baekeland grant of Flanders Innovation & Entrepreneurship (VLAIO), Deep learning, 1103 Clinical Sciences, Electrical Engineering and Systems Science - Image and Video Processing, Nuclear Medicine & Medical Imaging, 4603 Computer vision and multimedia computation, Artificial Intelligence (cs.AI), Surgery, Original Article, Clinical Competence, Life Sciences & Biomedicine
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