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Surgical instrument segmentation in laparoscopy is essential for computer-assisted surgical systems. Despite the Deep Learning progress in recent years, the dynamic setting of laparoscopic surgery still presents challenges for precise segmentation. The nnU-Net framework excelled in semantic segmentation analyzing single frames without temporal information. The framework's ease of use, including its ability to be automatically configured, and its low expertise requirements, have made it a popular base framework for comparisons. Optical flow (OF) is a tool commonly used in video tasks to estimate motion and represent it in a single frame, containing temporal information. This work seeks to employ OF maps as an additional input to the nnU-Net architecture to improve its performance in the surgical instrument segmentation task, taking advantage of the fact that instruments are the main moving objects in the surgical field. With this new input, the temporal component would be indirectly added without modifying the architecture. Using CholecSeg8k dataset, three different representations of movement were estimated and used as new inputs, comparing them with a baseline model. Results showed that the use of OF maps improves the detection of classes with high movement, even when these are scarce in the dataset. To further improve performance, future work may focus on implementing other OF-preserving augmentations.

Formalizing surgical activities as triplets of the used instruments, actions performed, and target anatomies is becoming a gold standard approach for surgical activity modeling. The benefit is that this formalization helps to obtain a more detailed understanding of tool-tissue interaction which can be used to develop better Artificial Intelligence assistance for image-guided surgery. Earlier efforts and the CholecTriplet challenge introduced in 2021 have put together techniques aimed at recognizing these triplets from surgical footage. Estimating also the spatial locations of the triplets would offer a more precise intraoperative context-aware decision support for computer-assisted intervention. This paper presents the CholecTriplet2022 challenge, which extends surgical action triplet modeling from recognition to detection. It includes weakly-supervised bounding box localization of every visible surgical instrument (or tool), as the key actors, and the modeling of each tool-activity in the form of triplet. The paper describes a baseline method and 10 new deep learning algorithms presented at the challenge to solve the task. It also provides thorough methodological comparisons of the methods, an in-depth analysis of the obtained results across multiple metrics, visual and procedural challenges; their significance, and useful insights for future research directions and applications in surgery., Comment: MICCAI EndoVis CholecTriplet2022 challenge report. Published at Elsevier journal of Medical Image Analysis. 25 pages, 15 figures, 8 tables