Artificial intelligence is set to be deployed in operating rooms to improve surgical care. This early-stage clinical evaluation shows the feasibility of concurrently attaining real-time, high-quality predictions from several deep neural networks for endoscopic video analysis deployed for assistance during three laparoscopic cholecystectomies.

Assessing the critical view of safety in laparoscopic cholecystectomy requires accurate identification and localization of key anatomical structures, reasoning about their geometric relationships to one another, and determining the quality of their exposure. In this work, we propose to capture each of these aspects by modeling the surgical scene with a disentangled latent scene graph representation, which we can then process using a graph neural network. Unlike previous approaches using graph representations, we explicitly encode in our graphs semantic information such as object locations and shapes, class probabilities and visual features. We also incorporate an auxiliary image reconstruction objective to help train the latent graph representations. We demonstrate the value of these components through comprehensive ablation studies and achieve state-of-the-art results for critical view of safety prediction across multiple experimental settings.

Context-aware decision support in the operating room can foster surgical safety and efficiency by leveraging real-time feedback from surgical workflow analysis. Most existing works recognize surgical activities at a coarse-grained level, such as phases, steps or events, leaving out fine-grained interaction details about the surgical activity; yet those are needed for more helpful AI assistance in the operating room. Recognizing surgical actions as triplets of <instrument, verb, target> combination delivers comprehensive details about the activities taking place in surgical videos. This paper presents CholecTriplet2021: an endoscopic vision challenge organized at MICCAI 2021 for the recognition of surgical action triplets in laparoscopic videos. The challenge granted private access to the large-scale CholecT50 dataset, which is annotated with action triplet information. In this paper, we present the challenge setup and assessment of the state-of-the-art deep learning methods proposed by the participants during the challenge. A total of 4 baseline methods from the challenge organizers and 19 new deep learning algorithms by competing teams are presented to recognize surgical action triplets directly from surgical videos, achieving mean average precision (mAP) ranging from 4.2% to 38.1%. This study also analyzes the significance of the results obtained by the presented approaches, performs a thorough methodological comparison between them, in-depth result analysis, and proposes a novel ensemble method for enhanced recognition. Our analysis shows that surgical workflow analysis is not yet solved, and also highlights interesting directions for future research on fine-grained surgical activity recognition which is of utmost importance for the development of AI in surgery.

Recent advancements in deep learning methods bring computer-assistance a step closer to fulfilling promises of safer surgical procedures. However, the generalizability of such methods is often dependent on training on diverse datasets from multiple medical institutions, which is a restrictive requirement considering the sensitive nature of medical data. Recently proposed collaborative learning methods such as Federated Learning (FL) allow for training on remote datasets without the need to explicitly share data. Even so, data annotation still represents a bottleneck, particularly in medicine and surgery where clinical expertise is often required. With these constraints in mind, we propose FedCy, a federated semi-supervised learning (FSSL) method that combines FL and self-supervised learning to exploit a decentralized dataset of both labeled and unlabeled videos, thereby improving performance on the task of surgical phase recognition. By leveraging temporal patterns in the labeled data, FedCy helps guide unsupervised training on unlabeled data towards learning task-specific features for phase recognition. We demonstrate significant performance gains over state-of-the-art FSSL methods on the task of automatic recognition of surgical phases using a newly collected multi-institutional dataset of laparoscopic cholecystectomy videos. Furthermore, we demonstrate that our approach also learns more generalizable features when tested on data from an unseen domain.

为有效语义分割和特别是视频语义分割构建模型的主要障碍是缺乏大型和良好的注释数据集。这种瓶颈在高度专业化的和监管领域特别禁止，例如医学和手术，视频语义细分可能具有重要应用，但数据和专家注释是稀缺的。在这些设置中，可以在培训期间利用时间线索和解剖结构来提高性能。在这里，我们呈现时间限制的神经网络（TCNN），是用于外科视频的视频语义分割的半监督框架。在这项工作中，我们表明AutoEncoder网络可用于有效地提供空间和时间监控信号来培训深度学习模型。我们在新推出的腹腔镜胆囊切除术文程序，内测序和对CADIS，CADIS的公共数据集的适应时测试我们的方法。我们证明，可以利用预测面罩的较低尺寸表示，以在稀疏标记的数据集中提供一致的改进，这些数据集在推理时间不具有额外的计算成本。此外，TCNN框架是模型无关的，可以与其他模型设计选择结合使用，具有最小的额外复杂性。

医疗AI通过支持基于证据的医学实践，个性化患者治疗，降低成本以及改善提供者和患者体验，推进医疗保健的巨大潜力。我们认为解锁此潜力需要一种系统的方法来衡量在大规模异构数据上的医疗AI模型的性能。为了满足这种需求，我们正在建立Medperf，这是一个开放的框架，用于在医疗领域的基准测试机器学习。 Medperf将使联合评估能够将模型安全地分配给不同的评估设施，从而赋予医疗组织在高效和人类监督过程中评估和验证AI模型的性能，同时优先考虑隐私。我们描述了当前的挑战医疗保健和AI社区面临，需要开放平台，Medperf的设计理念，其目前的实施状态和我们的路线图。我们呼吁研究人员和组织加入我们创建Medperf开放基准平台。

Real-world robotic grasping can be done robustly if a complete 3D Point Cloud Data (PCD) of an object is available. However, in practice, PCDs are often incomplete when objects are viewed from few and sparse viewpoints before the grasping action, leading to the generation of wrong or inaccurate grasp poses. We propose a novel grasping strategy, named 3DSGrasp, that predicts the missing geometry from the partial PCD to produce reliable grasp poses. Our proposed PCD completion network is a Transformer-based encoder-decoder network with an Offset-Attention layer. Our network is inherently invariant to the object pose and point's permutation, which generates PCDs that are geometrically consistent and completed properly. Experiments on a wide range of partial PCD show that 3DSGrasp outperforms the best state-of-the-art method on PCD completion tasks and largely improves the grasping success rate in real-world scenarios. The code and dataset will be made available upon acceptance.

Artificial neural networks can learn complex, salient data features to achieve a given task. On the opposite end of the spectrum, mathematically grounded methods such as topological data analysis allow users to design analysis pipelines fully aware of data constraints and symmetries. We introduce a class of persistence-based neural network layers. Persistence-based layers allow the users to easily inject knowledge about symmetries (equivariance) respected by the data, are equipped with learnable weights, and can be composed with state-of-the-art neural architectures.

Quantifying motion in 3D is important for studying the behavior of humans and other animals, but manual pose annotations are expensive and time-consuming to obtain. Self-supervised keypoint discovery is a promising strategy for estimating 3D poses without annotations. However, current keypoint discovery approaches commonly process single 2D views and do not operate in the 3D space. We propose a new method to perform self-supervised keypoint discovery in 3D from multi-view videos of behaving agents, without any keypoint or bounding box supervision in 2D or 3D. Our method uses an encoder-decoder architecture with a 3D volumetric heatmap, trained to reconstruct spatiotemporal differences across multiple views, in addition to joint length constraints on a learned 3D skeleton of the subject. In this way, we discover keypoints without requiring manual supervision in videos of humans and rats, demonstrating the potential of 3D keypoint discovery for studying behavior.

AI-based code generators are an emerging solution for automatically writing programs starting from descriptions in natural language, by using deep neural networks (Neural Machine Translation, NMT). In particular, code generators have been used for ethical hacking and offensive security testing by generating proof-of-concept attacks. Unfortunately, the evaluation of code generators still faces several issues. The current practice uses automatic metrics, which compute the textual similarity of generated code with ground-truth references. However, it is not clear what metric to use, and which metric is most suitable for specific contexts. This practical experience report analyzes a large set of output similarity metrics on offensive code generators. We apply the metrics on two state-of-the-art NMT models using two datasets containing offensive assembly and Python code with their descriptions in the English language. We compare the estimates from the automatic metrics with human evaluation and provide practical insights into their strengths and limitations.