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Video object segmentation (VOS) models such as SAM2 offer promising zero-shot tracking capabilities for surgical videos using minimal user input. Among the available input types, point-based tracking offers an efficient and low-cost alternative, yet its reliability and failure cases in complex surgical environments are not well understood. In this work, we systematically analyze the failure modes of point-based tracking in laparoscopic cholecystectomy videos. Focusing on three surgical targets, the gallbladder, grasper, and L-hook electrocautery, we compare the performance of point-based tracking with segmentation mask initialization. Our results show that point-based tracking is competitive for surgical tools but consistently underperforms for anatomical targets, where tissue similarity and ambiguous boundaries lead to failure. Through qualitative analysis, we reveal key factors influencing tracking outcomes and provide several actionable recommendations for selecting and placing tracking points to improve performance in surgical video analysis.

Deformable object manipulation is critical to many real-world robotic applications, ranging from surgical robotics and soft material handling in manufacturing to household tasks like laundry folding. At the core of this important robotic field is shape servoing, a task focused on controlling deformable objects into desired shapes. The shape servoing formulation requires the specification of a goal shape. However, most prior works in shape servoing rely on impractical goal shape acquisition methods, such as laborious domain-knowledge engineering or manual manipulation. DefGoalNet previously posed the current state-of-the-art solution to this problem, which learns deformable object goal shapes directly from a small number of human demonstrations. However, it significantly struggles in multi-modal settings, where multiple distinct goal shapes can all lead to successful task completion. As a deterministic model, DefGoalNet collapses these possibilities into a single averaged solution, often resulting in an unusable goal. In this paper, we address this problem by developing DefFusionNet, a novel neural network that leverages the diffusion probabilistic model to learn a distribution over all valid goal shapes rather than predicting a single deterministic outcome. This enables the generation of diverse goal shapes and avoids the averaging artifacts. We demonstrate our method's effectiveness on robotic tasks inspired by both manufacturing and surgical applications, both in simulation and on a physical robot. Our work is the first generative model capable of producing a diverse, multi-modal set of deformable object goals for real-world robotic applications.

Accurate pose estimation of surgical tools in Robot-assisted Minimally Invasive Surgery (RMIS) is essential for surgical navigation and robot control. While traditional marker-based methods offer accuracy, they face challenges with occlusions, reflections, and tool-specific designs. Similarly, supervised learning methods require extensive training on annotated datasets, limiting their adaptability to new tools. Despite their success in other domains, zero-shot pose estimation models remain unexplored in RMIS for pose estimation of surgical instruments, creating a gap in generalising to unseen surgical tools. This paper presents a novel 6 Degrees of Freedom (DoF) pose estimation pipeline for surgical instruments, leveraging state-of-the-art zero-shot RGB-D models like the FoundationPose and SAM-6D. We advanced these models by incorporating vision-based depth estimation using the RAFT-Stereo method, for robust depth estimation in reflective and textureless environments. Additionally, we enhanced SAM-6D by replacing its instance segmentation module, Segment Anything Model (SAM), with a fine-tuned Mask R-CNN, significantly boosting segmentation accuracy in occluded and complex conditions. Extensive validation reveals that our enhanced SAM-6D surpasses FoundationPose in zero-shot pose estimation of unseen surgical instruments, setting a new benchmark for zero-shot RGB-D pose estimation in RMIS. This work enhances the generalisability of pose estimation for unseen objects and pioneers the application of RGB-D zero-shot methods in RMIS.

Egocentric open-surgery videos capture rich, fine-grained details essential for accurately modeling surgical procedures and human behavior in the operating room. A detailed, pixel-level understanding of hands and surgical tools is crucial for interpreting a surgeon's actions and intentions. We introduce EgoSurgery-HTS, a new dataset with pixel-wise annotations and a benchmark suite for segmenting surgical tools, hands, and interacting tools in egocentric open-surgery videos. Specifically, we provide a labeled dataset for (1) tool instance segmentation of 14 distinct surgical tools, (2) hand instance segmentation, and (3) hand-tool segmentation to label hands and the tools they manipulate. Using EgoSurgery-HTS, we conduct extensive evaluations of state-of-the-art segmentation methods and demonstrate significant improvements in the accuracy of hand and hand-tool segmentation in egocentric open-surgery videos compared to existing datasets. The dataset will be released at https://github.com/Fujiry0/EgoSurgery.

Robot pose estimation is a challenging and crucial task for vision-based surgical robotic automation. Typical robotic calibration approaches, however, are not applicable to surgical robots, such as the da Vinci Research Kit (dVRK), due to joint angle measurement errors from cable-drives and the partially visible kinematic chain. Hence, previous works in surgical robotic automation used tracking algorithms to estimate the pose of the surgical tool in real-time and compensate for the joint angle errors. However, a big limitation of these previous tracking works is the initialization step which relied on only keypoints and SolvePnP. In this work, we fully explore the potential of geometric primitives beyond just keypoints with differentiable rendering, cylinders, and construct a versatile pose matching pipeline in a novel pose hypothesis space. We demonstrate the state-of-the-art performance of our single-shot calibration method with both calibration consistency and real surgical tasks. As a result, this marker-less calibration approach proves to be a robust and generalizable initialization step for surgical tool tracking.

Surgical guidance can be delivered in various ways. In neurosurgery, spatial guidance and orientation are predominantly achieved through neuronavigation systems that reference pre-operative MRI scans. Recently, there has been growing interest in providing live guidance by analyzing video feeds from tools such as endoscopes. Existing approaches, including anatomy detection, orientation feedback, phase recognition, and visual question-answering, primarily focus on aiding surgeons in assessing the current surgical scene. This work aims to provide guidance on a finer scale, aiming to provide guidance by forecasting the trajectory of the surgical instrument, essentially addressing the question of what to do next. To address this task, we propose a model that not only leverages the historical locations of surgical instruments but also integrates anatomical features. Importantly, our work does not rely on explicit ground truth labels for instrument trajectories. Instead, the ground truth is generated by a detection model trained to detect both anatomical structures and instruments within surgical videos of a comprehensive dataset containing pituitary surgery videos. By analyzing the interaction between anatomy and instrument movements in these videos and forecasting future instrument movements, we show that anatomical features are a valuable asset in addressing this challenging task. To the best of our knowledge, this work is the first attempt to address this task for manually operated surgeries.

Accurate instrument pose estimation is a crucial step towards the future of robotic surgery, enabling applications such as autonomous surgical task execution. Vision-based methods for surgical instrument pose estimation provide a practical approach to tool tracking, but they often require markers to be attached to the instruments. Recently, more research has focused on the development of marker-less methods based on deep learning. However, acquiring realistic surgical data, with ground truth instrument poses, required for deep learning training, is challenging. To address the issues in surgical instrument pose estimation, we introduce the Surgical Robot Instrument Pose Estimation (SurgRIPE) challenge, hosted at the 26th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI) in 2023. The objectives of this challenge are: (1) to provide the surgical vision community with realistic surgical video data paired with ground truth instrument poses, and (2) to establish a benchmark for evaluating markerless pose estimation methods. The challenge led to the development of several novel algorithms that showcased improved accuracy and robustness over existing methods. The performance evaluation study on the SurgRIPE dataset highlights the potential of these advanced algorithms to be integrated into robotic surgery systems, paving the way for more precise and autonomous surgical procedures. The SurgRIPE challenge has successfully established a new benchmark for the field, encouraging further research and development in surgical robot instrument pose estimation.

Automated assessment of surgical skills using artificial intelligence (AI) provides trainees with instantaneous feedback. After bimanual tool motions are captured, derived kinematic metrics are reliable predictors of performance in laparoscopic tasks. Implementing automated tool tracking requires time-intensive human annotation. We developed AI-based tool tracking using the Segment Anything Model (SAM) to eliminate the need for human annotators. Here, we describe a study evaluating the usefulness of our tool tracking model in automated assessment during a laparoscopic suturing task in the fundoplication procedure. An automated tool tracking model was applied to recorded videos of Nissen fundoplication on porcine bowel. Surgeons were grouped as novices (PGY1-2) and experts (PGY3-5, attendings). The beginning and end of each suturing step were segmented, and motions of the left and right tools were extracted. A low-pass filter with a 24 Hz cut-off frequency removed noise. Performance was assessed using supervised and unsupervised models, and an ablation study compared results. Kinematic features--RMS velocity, RMS acceleration, RMS jerk, total path length, and Bimanual Dexterity--were extracted and analyzed using Logistic Regression, Random Forest, Support Vector Classifier, and XGBoost. PCA was performed for feature reduction. For unsupervised learning, a Denoising Autoencoder (DAE) model with classifiers, such as a 1-D CNN and traditional models, was trained. Data were extracted for 28 participants (9 novices, 19 experts). Supervised learning with PCA and Random Forest achieved an accuracy of 0.795 and an F1 score of 0.778. The unsupervised 1-D CNN achieved superior results with an accuracy of 0.817 and an F1 score of 0.806, eliminating the need for kinematic feature computation. We demonstrated an AI model capable of automated performance classification, independent of human annotation.

Minimally invasive surgery (MIS) procedures benefit significantly from robotic systems due to their improved precision and dexterity. However, ensuring safety in these dynamic and cluttered environments is an ongoing challenge. This paper proposes a novel hierarchical framework for collision avoidance in MIS. This framework integrates multiple tasks, including maintaining the Remote Center of Motion (RCM) constraint, tracking desired tool poses, avoiding collisions, optimizing manipulability, and adhering to joint limits. The proposed approach utilizes Hierarchical Quadratic Programming (HQP) to seamlessly manage these constraints while enabling smooth transitions between task priorities for collision avoidance. Experimental validation through simulated scenarios demonstrates the framework's robustness and effectiveness in handling diverse scenarios involving static and dynamic obstacles, as well as inter-tool collisions.