# ETSM: Automating Dissection Trajectory Suggestion and Confidence Map-Based Safety Margin Prediction for Robot-assisted Endoscopic Submucosal Dissection

arXiv: https://arxiv.org/abs/2411.18884 · HTML: https://mlsanity.com/paper/2411.18884/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 27 references that are in the map.
- First posted on arXiv 28 Nov 2024.

## Builds on (most cited first, 15 of 15)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Benchmarking Neural Network Robustness to Common Corruptions and Perturbations](https://mlsanity.com/paper/1903.12261/) (2019)
- [Rethinking Semantic Segmentation from a Sequence-to-Sequence Perspective with Transformers](https://mlsanity.com/paper/2012.15840/) (2020)
- [Exploring the Limitations of Behavior Cloning for Autonomous Driving](https://mlsanity.com/paper/1904.08980/) (2019)
- [Social-STGCNN: A Social Spatio-Temporal Graph Convolutional Neural Network for Human Trajectory Prediction](https://mlsanity.com/paper/2002.11927/) (2020)
- [Stochastic Trajectory Prediction via Motion Indeterminacy Diffusion](https://mlsanity.com/paper/2203.13777/) (2022)
- [Deep Dual-resolution Networks for Real-time and Accurate Semantic Segmentation of Road Scenes](https://mlsanity.com/paper/2101.06085/) (2021)
- [Boosting Crowd Counting via Multifaceted Attention](https://mlsanity.com/paper/2203.02636/) (2022)
- [Recursive Social Behavior Graph for Trajectory Prediction](https://mlsanity.com/paper/2004.10402/) (2020)
- [daVinciNet: Joint Prediction of Motion and Surgical State in Robot-Assisted Surgery](https://mlsanity.com/paper/2009.11937/) (2020)
- [Symmetric Dilated Convolution for Surgical Gesture Recognition](https://mlsanity.com/paper/2007.06373/) (2020)

## Built on by (most cited first, 3 of 3)

- [BleedOrigin: Dynamic Bleeding Source Localization in Endoscopic Submucosal Dissection via Dual-Stage Detection and Tracking](https://mlsanity.com/paper/2507.15094/) (2025)
- [SurgAtt-Tracker: Online Surgical Attention Tracking via Temporal Proposal Reranking and Motion-Aware Refinement](https://mlsanity.com/paper/2602.20636/) (2026)
- [GeoCFNet: Geometry-Aware Confidence Field Network for Robot-Assisted Endoscopic Submucosal Dissection](https://mlsanity.com/paper/2606.13032/) (2026)

## Abstract (arXiv)

Robot-assisted Endoscopic Submucosal Dissection (ESD) improves the surgical procedure by providing a more comprehensive view through advanced robotic instruments and bimanual operation, thereby enhancing dissection efficiency and accuracy. Accurate prediction of dissection trajectories is crucial for better decision-making, reducing intraoperative errors, and improving surgical training. Nevertheless, predicting these trajectories is challenging due to variable tumor margins and dynamic visual conditions. To address this issue, we create the ESD Trajectory and Confidence Map-based Safety Margin (ETSM) dataset with 1849 short clips, focusing on submucosal dissection with a dual-arm robotic system. We also introduce a framework that combines optimal dissection trajectory prediction with a confidence map-based safety margin, providing a more secure and intelligent decision-making tool to minimize surgical risks for ESD procedures. Additionally, we propose the Regression-based Confidence Map Prediction Network (RCMNet), which utilizes a regression approach to predict confidence maps for dissection areas, thereby delineating various levels of safety margins. We evaluate our RCMNet using three distinct experimental setups: in-domain evaluation, robustness assessment, and out-of-domain evaluation. Experimental results show that our approach excels in the confidence map-based safety margin prediction task, achieving a mean absolute error (MAE) of only 3.18. To the best of our knowledge, this is the first study to apply a regression approach for visual guidance concerning delineating varying safety levels of dissection areas. Our approach bridges gaps in current research by improving prediction accuracy and enhancing the safety of the dissection process, showing great clinical significance in practice.