We apply brain dissection across the visual cortex to uncover functional differences between regions.

We apply brain dissection across the visual cortex to uncover functional differences between regions.

Robotic surgery offers enhanced precision and adaptability, paving the way for automation in surgical interventions. Cholecystectomy, the gallbladder removal, is particularly well-suited for automation due to its standardized procedural steps and distinct anatomical boundaries. A key challenge in automating this procedure is dissecting with accuracy and adaptability. This paper presents a vision-based autonomous robotic dissection architecture that integrates real-time segmentation, keypoint detection, grasping and stretching the gallbladder with the left arm, and dissecting with the other. We introduce an improved segmentation dataset based on videos of robotic cholecystectomy performed by various surgeons, incorporating a new ``liver bed'' class to enhance boundary tracking after multiple rounds of dissection. Our system employs state-of-the-art segmentation models and an adaptive boundary extraction method that maintains accuracy despite tissue deformations and visual variations. Moreover, we implemented an automated grasping and pulling strategy to optimize tissue tension before dissection upon our previous work. Ex vivo evaluations on porcine livers demonstrate that our framework significantly improves dissection precision and consistency, marking a step toward fully autonomous robotic cholecystectomy.

Surgical automation has the capability to improve the consistency of patient outcomes and broaden access to advanced surgical care in underprivileged communities. Shared autonomy, where the robot automates routine subtasks while the surgeon retains partial teleoperative control, offers great potential to make an impact. In this paper we focus on one important skill within surgical shared autonomy: Automating robotic assistance to maximize visual exposure and apply tissue tension for dissection and cautery. Ensuring consistent exposure to visualize the surgical site is crucial for both efficiency and patient safety. However, achieving this is highly challenging due to the complexities of manipulating deformable volumetric tissues that are prevalent in surgery.To address these challenges we propose \methodname, a framework for autonomous surgical robotic assistance to \methodfullname. We integrate a differentiable physics model with perceptual feedback to achieve our two key objectives: 1) Maximizing tissue exposure and applying tension for a specified dissection site through visual-servoing conrol and 2) Selecting optimal control positions for a dissection target based on deformable Jacobian analysis. We quantitatively assess our method through repeated real robot experiments on a tissue phantom, and showcase its capabilities through dissection experiments using shared autonomy on real animal tissue.

Diffusion-based video generation models have made significant strides, producing outputs with improved visual fidelity, temporal coherence, and user control. These advancements hold great promise for improving surgical education by enabling more realistic, diverse, and interactive simulation environments. In this study, we introduce SurGen, a text-guided diffusion model tailored for surgical video synthesis, producing the highest resolution and longest duration videos among existing surgical video generation models. We validate the visual and temporal quality of the outputs using standard image and video generation metrics. Additionally, we assess their alignment to the corresponding text prompts through a deep learning classifier trained on surgical data. Our results demonstrate the potential of diffusion models to serve as valuable educational tools for surgical trainees.

This paper presents the Holistic and Multi-Granular Surgical Scene Understanding of Prostatectomies (GraSP) dataset, a curated benchmark that models surgical scene understanding as a hierarchy of complementary tasks with varying levels of granularity. Our approach enables a multi-level comprehension of surgical activities, encompassing long-term tasks such as surgical phases and steps recognition and short-term tasks including surgical instrument segmentation and atomic visual actions detection. To exploit our proposed benchmark, we introduce the Transformers for Actions, Phases, Steps, and Instrument Segmentation (TAPIS) model, a general architecture that combines a global video feature extractor with localized region proposals from an instrument segmentation model to tackle the multi-granularity of our benchmark. Through extensive experimentation, we demonstrate the impact of including segmentation annotations in short-term recognition tasks, highlight the varying granularity requirements of each task, and establish TAPIS's superiority over previously proposed baselines and conventional CNN-based models. Additionally, we validate the robustness of our method across multiple public benchmarks, confirming the reliability and applicability of our dataset. This work represents a significant step forward in Endoscopic Vision, offering a novel and comprehensive framework for future research towards a holistic understanding of surgical procedures.

Recent advances in synthetic imaging open up opportunities for obtaining additional data in the field of surgical imaging. This data can provide reliable supplements supporting surgical applications and decision-making through computer vision. Particularly the field of image-guided surgery, such as laparoscopic and robotic-assisted surgery, benefits strongly from synthetic image datasets and virtual surgical training methods. Our study presents an intuitive approach for generating synthetic laparoscopic images from short text prompts using diffusion-based generative models. We demonstrate the usage of state-of-the-art text-to-image architectures in the context of laparoscopic imaging with regard to the surgical removal of the gallbladder as an example. Results on fidelity and diversity demonstrate that diffusion-based models can acquire knowledge about the style and semantics in the field of image-guided surgery. A validation study with a human assessment survey underlines the realistic nature of our synthetic data, as medical personnel detects actual images in a pool with generated images causing a false-positive rate of 66%. In addition, the investigation of a state-of-the-art machine learning model to recognize surgical actions indicates enhanced results when trained with additional generated images of up to 5.20%. Overall, the achieved image quality contributes to the usage of computer-generated images in surgical applications and enhances its path to maturity.

Automatic aorta segmentation from 3-D medical volumes is an important yet difficult task. Several factors make the problem challenging, e.g. the possibility of aortic dissection or the difficulty with segmenting and annotating the small branches. This work presents a contribution by the MedGIFT team to the SEG.A challenge organized during the MICCAI 2023 conference. We propose a fully automated algorithm based on deep encoder-decoder architecture. The main assumption behind our work is that data preprocessing and augmentation are much more important than the deep architecture, especially in low data regimes. Therefore, the solution is based on a variant of traditional convolutional U-Net. The proposed solution achieved a Dice score above 0.9 for all testing cases with the highest stability among all participants. The method scored 1st, 4th, and 3rd in terms of the clinical evaluation, quantitative results, and volumetric meshing quality, respectively. We freely release the source code, pretrained model, and provide access to the algorithm on the Grand-Challenge platform.

Robotic surgery promises enhanced precision and adaptability over traditional surgical methods. It also offers the possibility of automating surgical interventions, resulting in reduced stress on the surgeon, better surgical outcomes, and lower costs. Cholecystectomy, the removal of the gallbladder, serves as an ideal model procedure for automation due to its distinct and well-contrasted anatomical features between the gallbladder and liver, along with standardized surgical maneuvers. Dissection is a frequently used subtask in cholecystectomy where the surgeon delivers the energy on the hook to detach the gallbladder from the liver. Hence, dissection along tissue boundaries is a good candidate for surgical automation. For the da Vinci surgical robot to perform the same procedure as a surgeon automatically, it needs to have the ability to (1) recognize and distinguish between the two different tissues (e.g. the liver and the gallbladder), (2) understand where the boundary between the two tissues is located in the 3D workspace, (3) locate the instrument tip relative to the boundary in the 3D space using visual feedback, and (4) move the instrument along the boundary. This paper presents a novel framework that addresses these challenges through AI-assisted image processing and vision-based robot control. We also present the ex-vivo evaluation of the automated procedure on chicken and pork liver specimens that demonstrates the effectiveness of the proposed framework.

Modern deep networks are highly complex and their inferential outcome very hard to interpret. This is a serious obstacle to their transparent deployment in safety-critical or bias-aware applications. This work contributes to post-hoc interpretability, and specifically Network Dissection. Our goal is to present a framework that makes it easier to discover the individual functionality of each neuron in a network trained on a vision task; discovery is performed in terms of textual description generation. To achieve this objective, we leverage: (i) recent advances in multimodal vision-text models and (ii) network layers founded upon the novel concept of stochastic local competition between linear units. In this setting, only a small subset of layer neurons are activated for a given input, leading to extremely high activation sparsity (as low as only $\approx 4\%$). Crucially, our proposed method infers (sparse) neuron activation patterns that enables the neurons to activate/specialize to inputs with specific characteristics, diversifying their individual functionality. This capacity of our method supercharges the potential of dissection processes: human understandable descriptions are generated only for the very few active neurons, thus facilitating the direct investigation of the network's decision process. As we experimentally show, our approach: (i) yields Vision Networks that retain or improve classification performance, and (ii) realizes a principled framework for text-based description and examination of the generated neuronal representations.