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Real-time automatic surgical phase recognition in laparoscopic sigmoidectomy using the convolutional neural network-based deep learning approach

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Abstract

Background

Automatic surgical workflow recognition is a key component for developing the context-aware computer-assisted surgery (CA-CAS) systems. However, automatic surgical phase recognition focused on colorectal surgery has not been reported. We aimed to develop a deep learning model for automatic surgical phase recognition based on laparoscopic sigmoidectomy (Lap-S) videos, which could be used for real-time phase recognition, and to clarify the accuracies of the automatic surgical phase and action recognitions using visual information.

Methods

The dataset used contained 71 cases of Lap-S. The video data were divided into frame units every 1/30 s as static images. Every Lap-S video was manually divided into 11 surgical phases (Phases 0–10) and manually annotated for each surgical action on every frame. The model was generated based on the training data. Validation of the model was performed on a set of unseen test data. Convolutional neural network (CNN)-based deep learning was also used.

Results

The average surgical time was 175 min (± 43 min SD), with the individual surgical phases also showing high variations in the duration between cases. Each surgery started in the first phase (Phase 0) and ended in the last phase (Phase 10), and phase transitions occurred 14 (± 2 SD) times per procedure on an average. The accuracy of the automatic surgical phase recognition was 91.9% and those for the automatic surgical action recognition of extracorporeal action and irrigation were 89.4% and 82.5%, respectively. Moreover, this system could perform real-time automatic surgical phase recognition at 32 fps.

Conclusions

The CNN-based deep learning approach enabled the recognition of surgical phases and actions in 71 Lap-S cases based on manually annotated data. This system could perform automatic surgical phase recognition and automatic target surgical action recognition with high accuracy. Moreover, this study showed the feasibility of real-time automatic surgical phase recognition with high frame rate.

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Funding

This research was supported by Japan Agency for Medical Research and Development (AMED) under Grant Number JP18he1802002.

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Authors and Affiliations

  1. Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-City, Chiba, 277-8577, Japan

    Daichi Kitaguchi, Nobuyoshi Takeshita & Masaaki Ito

  2. Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-City, Chiba, 277-8577, Japan

    Daichi Kitaguchi, Nobuyoshi Takeshita, Hiroki Matsuzaki, Hiroaki Takano & Masaaki Ito

  3. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan

    Daichi Kitaguchi, Yohei Owada, Tsuyoshi Enomoto & Tatsuya Oda

  4. Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, 252-0374, Japan

    Hirohisa Miura, Takahiro Yamanashi & Masahiko Watanabe

  5. MICIN, Inc, Nihon Bldg 13F, Otemachi, Chiyoda-ku, Tokyo, 100-0004, Japan

    Daisuke Sato, Yusuke Sugomori & Seigo Hara

Authors
  1. Daichi Kitaguchi
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  2. Nobuyoshi Takeshita
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Corresponding author

Correspondence to Nobuyoshi Takeshita.

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Disclosures

Daichi Kitaguchi, Nobuyoshi Takeshita, Hiroki Matsuzaki, Hiroki Takano, Yohei Owada, Tsuyoshi Enomoto, Tatsuya Oda, Hirohisa Miura, Takahiro Yamanashi, Masahiko Watanabe, Daisuke Sato, Yusuke Sugomori, Seigo Hara and Masaaaki Ito have no conflicts of interest or financial ties to disclose.

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Kitaguchi, D., Takeshita, N., Matsuzaki, H. et al. Real-time automatic surgical phase recognition in laparoscopic sigmoidectomy using the convolutional neural network-based deep learning approach. Surg Endosc 34, 4924–4931 (2020). https://doi.org/10.1007/s00464-019-07281-0

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