# Automated Surgical Skill Assessment in Endoscopic Pituitary Surgery using Real-time Instrument Tracking on a High-fidelity Bench-top Phantom

arXiv: https://arxiv.org/abs/2409.17025 · HTML: https://mlsanity.com/paper/2409.17025/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 39 references that are in the map.
- First posted on arXiv 25 Sep 2024.

## Builds on (most cited first, 11 of 11)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Rethinking Atrous Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1706.05587/) (2017)
- [Simple Online and Realtime Tracking with a Deep Association Metric](https://mlsanity.com/paper/1703.07402/) (2017)
- [Simple Online and Realtime Tracking](https://mlsanity.com/paper/1602.00763/) (2016)
- [StrongSORT: Make DeepSORT Great Again](https://mlsanity.com/paper/2202.13514/) (2022)
- [Methods and datasets for segmentation of minimally invasive surgical instruments in endoscopic images and videos: A review of the state of the art](https://mlsanity.com/paper/2304.13014/) (2023)
- [PitVis-2023 Challenge: Workflow Recognition in videos of Endoscopic Pituitary Surgery](https://mlsanity.com/paper/2409.01184/) (2024)
- [A surgical dataset from the da Vinci Research Kit for task automation and recognition](https://mlsanity.com/paper/2102.03643/) (2021)
- [Towards Deterministic End-to-end Latency for Medical AI Systems in NVIDIA Holoscan](https://mlsanity.com/paper/2402.04466/) (2024)

## Abstract (arXiv)

Improved surgical skill is generally associated with improved patient outcomes, although assessment is subjective; labour-intensive; and requires domain specific expertise. Automated data driven metrics can alleviate these difficulties, as demonstrated by existing machine learning instrument tracking models in minimally invasive surgery. However, these models have been tested on limited datasets of laparoscopic surgery, with a focus on isolated tasks and robotic surgery. In this paper, a new public dataset is introduced, focusing on simulated surgery, using the nasal phase of endoscopic pituitary surgery as an exemplar. Simulated surgery allows for a realistic yet repeatable environment, meaning the insights gained from automated assessment can be used by novice surgeons to hone their skills on the simulator before moving to real surgery. PRINTNet (Pituitary Real-time INstrument Tracking Network) has been created as a baseline model for this automated assessment. Consisting of DeepLabV3 for classification and segmentation; StrongSORT for tracking; and the NVIDIA Holoscan SDK for real-time performance, PRINTNet achieved 71.9% Multiple Object Tracking Precision running at 22 Frames Per Second. Using this tracking output, a Multilayer Perceptron achieved 87% accuracy in predicting surgical skill level (novice or expert), with the "ratio of total procedure time to instrument visible time" correlated with higher surgical skill. This therefore demonstrates the feasibility of automated surgical skill assessment in simulated endoscopic pituitary surgery. The new publicly available dataset can be found here: https://doi.org/10.5522/04/26511049.