SurgiATM: A Physics-Guided Plug-and-Play Model for Deep Learning-Based Smoke Removal in Laparoscopic Surgery

During laparoscopic surgery, smoke generated by tissue cauterization can significantly degrade the visual quality of endoscopic frames, increasing the risk of surgical errors and hindering both clinical decision-making and computer-assisted visual analysis. Consequently, removing surgical smoke is critical to ensuring patient safety and maintaining operative efficiency. In this study, we propose the Surgical Atmospheric Model (SurgiATM) for surgical smoke removal. SurgiATM statistically bridges a physics-based atmospheric model and data-driven deep learning models, combining the superior generalizability of the former with the high accuracy of the latter. Furthermore, SurgiATM is designed as a lightweight module that can be easily integrated into existing surgical desmoking architectures with minimal modification, aiming to enhance their accuracy and stability. The proposed method is derived via statistically optimizing a Mixture-of-Experts (MoE) model at the output end of arbitrary deep learning methods, with a Laplacian-like error distribution specifically leveraged to model surgical smoke. The output-stage MoE ensures minimal modification to the architecture of the original methods, while the Laplacian-like distribution characteristic of surgical smoke enables a lightweight reconstruction formulation with minimal parameters. Therefore, SurgiATM introduces only two hyperparameters and no additional trainable weights, preserving the original network architecture with minimal computational and modification overhead. We conduct extensive experiments on three public surgical datasets with ten desmoking methods, involving multiple network architectures and covering diverse procedures, including cholecystectomy, partial nephrectomy, and diaphragm dissection.