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OperA: Attention-Regularized Transformers for Surgical Phase Recognition

arXiv 2103.03873 ↗First posted 5 Mar 2021cs.CV cs.AIcited by 60

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Abstract (arXiv)

In this paper we introduce OperA, a transformer-based model that accurately predicts surgical phases from long video sequences. A novel attention regularization loss encourages the model to focus on high-quality frames during training. Moreover, the attention weights are utilized to identify characteristic high attention frames for each surgical phase, which could further be used for surgery summarization. OperA is thoroughly evaluated on two datasets of laparoscopic cholecystectomy videos, outperforming various state-of-the-art temporal refinement approaches.

Key facts. Cited by 60 papers in the map (data through 7 Oct 2026). Builds on 19 of its 28 references that are in the map. First posted on arXiv 5 Mar 2021.

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19 of 28 references.

References · 19

  1. 2017Attention Is All You Needcited by 59,932
  2. 2015Deep Residual Learning for Image Recognitioncited by 51,809
  3. 2018BERT: Pre-training of Deep Bidirectional Transformers for Language Understandingcited by 40,204
  4. 2020Language Models are Few-Shot Learnerscited by 32,199
  5. 2020An Image is Worth 16x16 Words: Transformers for Image Recognition at Scalecited by 29,915
  6. 2016Layer Normalizationcited by 5,579
  7. 2021Zero-Shot Text-to-Image Generationcited by 4,276
  8. 2019Attention is not Explanationcited by 916
  9. 2019Attention is not not Explanationcited by 629
  10. 2014Predicting Depth, Surface Normals and Semantic Labels with a Common Multi-Scale Convolutional Architecturecited by 483
  11. 2016EndoNet: A Deep Architecture for Recognition Tasks on Laparoscopic Videoscited by 366
  12. 2020TeCNO: Surgical Phase Recognition with Multi-Stage Temporal Convolutional Networkscited by 139
7 more
  1. 2018Character-Level Language Modeling with Deeper Self-Attentioncited by 138
  2. 2017Structured Attention Networkscited by 95
  3. 2019Multi-Task Recurrent Convolutional Network with Correlation Loss for Surgical Video Analysiscited by 75
  4. 2019Video-based surgical skill assessment using 3D convolutional neural networkscited by 57
  5. 2018Less is More: Surgical Phase Recognition with Less Annotations through Self-Supervised Pre-training of CNN-LSTM Networkscited by 24
  6. 2019Offline identification of surgical deviations in laparoscopic rectopexycited by 12
  7. 2018Surgical Data Science: A Consensus Perspectivecited by 5

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Citing papers per year: 2021: 2; 2022: 13; 2023: 16; 2024: 15; 2025: 10; 2026: 4.

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  1. 2021Rendezvous: Attention Mechanisms for the Recognition of Surgical Action Triplets in Endoscopic Videoscited by 139
  2. 2023Learning Multi-modal Representations by Watching Hundreds of Surgical Video Lecturescited by 68
  3. 2023Advances in Medical Image Analysis with Vision Transformers: A Comprehensive Reviewcited by 62
  4. 2023LoViT: Long Video Transformer for Surgical Phase Recognitioncited by 56
  5. 2022Dissecting Self-Supervised Learning Methods for Surgical Computer Visioncited by 48
  6. 2024Pixel-Wise Recognition for Holistic Surgical Scene Understandingcited by 48
  7. 2022Transformers in Medical Image Analysis: A Reviewcited by 41
  8. 2022Towards Holistic Surgical Scene Understandingcited by 33
  9. 2024OphNet: A Large-Scale Video Benchmark for Ophthalmic Surgical Workflow Understandingcited by 31
  10. 2025MM-OR: A Large Multimodal Operating Room Dataset for Semantic Understanding of High-Intensity Surgical Environmentscited by 28
  11. 2022Exploring Intra- and Inter-Video Relation for Surgical Semantic Scene Segmentationcited by 27
  12. 2023CholecTriplet2022: Show me a tool and tell me the triplet -- an endoscopic vision challenge for surgical action triplet detectioncited by 22
38 more
  1. 2023Dynamic Scene Graph Representation for Surgical Videocited by 21
  2. 2021Not End-to-End: Explore Multi-Stage Architecture for Online Surgical Phase Recognitioncited by 20
  3. 2022On the Pitfalls of Batch Normalization for End-to-End Video Learning: A Study on Surgical Workflow Analysiscited by 19
  4. 2022Less is More: Surgical Phase Recognition from Timestamp Supervisioncited by 13
  5. 2023Metrics Matter in Surgical Phase Recognitioncited by 13
  6. 2024Surgical Workflow Recognition and Blocking Effectiveness Detection in Laparoscopic Liver Resections with Pringle Maneuvercited by 12
  7. 2024VidLPRO: A underlineVideo-underlineLanguage underlinePre-training Framework for underlineRobotic and Laparoscopic Surgerycited by 12
  8. 2025EgoExOR: An Ego-Exo-Centric Operating Room Dataset for Surgical Activity Understandingcited by 11
  9. 2023Self-distillation for surgical action recognitioncited by 9
  10. 2024Creating a Digital Twin of Spinal Surgery: A Proof of Conceptcited by 9
  11. 2023Pelphix: Surgical Phase Recognition from X-ray Images in Percutaneous Pelvic Fixationcited by 8
  12. 2024MuST: Multi-Scale Transformers for Surgical Phase Recognitioncited by 8
  13. 2022Retrieval of surgical phase transitions using reinforcement learningcited by 7
  14. 2022Know your sensORs -- A Modality Study For Surgical Action Classificationcited by 6
  15. 2022Surgical Workflow Recognition: from Analysis of Challenges to Architectural Studycited by 6
  16. 2022ARST: Auto-Regressive Surgical Transformer for Phase Recognition from Laparoscopic Videoscited by 6
  17. 2023TUNeS: A Temporal U-Net with Self-Attention for Video-based Surgical Phase Recognitioncited by 6
  18. 2023Surgical Temporal Action-aware Network with Sequence Regularization for Phase Recognitioncited by 6
  19. 2023SF-TMN: SlowFast Temporal Modeling Network for Surgical Phase Recognitioncited by 5
  20. 2024SR-Mamba: Effective Surgical Phase Recognition with State Space Modelcited by 5
  21. 2022MURPHY: Relations Matter in Surgical Workflow Analysiscited by 3
  22. 2024DACAT: Dual-stream Adaptive Clip-aware Time Modeling for Robust Online Surgical Phase Recognitioncited by 3
  23. 2024SPRMamba: Surgical Phase Recognition for Endoscopic Submucosal Dissection with Mambacited by 3
  24. 2024Friends Across Time: Multi-Scale Action Segmentation Transformer for Surgical Phase Recognitioncited by 2
  25. 2024SuPRA: Surgical Phase Recognition and Anticipation for Intra-Operative Planningcited by 2
  26. 2024ViTALS: Vision Transformer for Action Localization in Surgical Nephrectomycited by 2
  27. 2024SurgPLAN++: Universal Surgical Phase Localization Network for Online and Offline Inferencecited by 2
  28. 2025ArthroPhase: A Novel Dataset and Method for Phase Recognition in Arthroscopic Videocited by 2
  29. 2025Hierarchical Context Transformer for Multi-level Semantic Scene Understandingcited by 2
  30. 2022Quantification of Robotic Surgeries with Vision-Based Deep Learningcited by 1
  31. 2024Surgment: Segmentation-enabled Semantic Search and Creation of Visual Question and Feedback to Support Video-Based Surgery Learningcited by 1
  32. 2025A Temporal Convolutional Network-Based Approach and a Benchmark Dataset for Colonoscopy Video Temporal Segmentationcited by 1
  33. 2025Surgeons vs. Computer Vision: A comparative analysis on surgical phase recognition capabilitiescited by 1
  34. 2022Surgical Phase Recognition in Laparoscopic Cholecystectomycited by 0
  35. 2023Shifted-Windows Transformers for the Detection of Cerebral Aneurysms in Microsurgerycited by 0
  36. 2023Surgical Phase and Instrument Recognition: How to identify appropriate Dataset Splitscited by 0
  37. 2023Hierarchical Semi-Supervised Learning Framework for Surgical Gesture Segmentation and Recognition Based on Multi-Modality Datacited by 0
  38. 2023Phase-Specific Augmented Reality Guidance for Microscopic Cataract Surgery Using Long-Short Spatiotemporal Aggregation Transformercited by 0

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