# First Investigation of Deep Learning for Intraoperative Gauze Segmentation in Minimally Invasive Abdominal Surgery

arXiv: https://arxiv.org/abs/2607.29132 · HTML: https://mlsanity.com/paper/2607.29132/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 15 of its 42 references that are in the map.
- First posted on arXiv 31 Jul 2026.

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

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [You Only Look Once: Unified, Real-Time Object Detection](https://mlsanity.com/paper/1506.02640/) (2015)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Masked-attention Mask Transformer for Universal Image Segmentation](https://mlsanity.com/paper/2112.01527/) (2021)
- [Rethinking Atrous Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1706.05587/) (2017)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [EndoNet: A Deep Architecture for Recognition Tasks on Laparoscopic Videos](https://mlsanity.com/paper/1602.03012/) (2016)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [Metrics reloaded: Recommendations for image analysis validation](https://mlsanity.com/paper/2206.01653/) (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)
- [Deep learning approaches to surgical video segmentation and object detection: A Scoping Review](https://mlsanity.com/paper/2502.16459/) (2025)
- [Informed Deep Abstaining Classifier: Investigating noise-robust training for diagnostic decision support systems](https://mlsanity.com/paper/2410.21014/) (2024)
- [Medical Image Segmentation with SAM-generated Annotations](https://mlsanity.com/paper/2409.20253/) (2024)

## Abstract (arXiv)

Surgical gauze is an essential part of surgical procedures, primarily used for controlling bleeding and absorbing bodily fluids. The post-surgical retention of gauze can lead to serious complications and necessitate additional surgery for its removal. Despite the clinical significance, research on gauze segmentation using real-world surgical data remains underexplored, owing in part to the scarcity of annotated datasets. In this work, we investigate the use of deep learning methods for gauze segmentation in robot-assisted minimally invasive abdominal surgeries, utilizing an in-house surgical dataset prepared at a university hospital. The training data reflects realistic surgical settings and captures extensive diversity in spatial, morphological, and visual attributes across three different gauze categories. We evaluate several widely used segmentation architectures, including CNN-based, transformer-based, and hybrid architectures, to establish a proof-of-concept for gauze segmentation in a realistic clinical setting. In addition, we investigate the influence of sub-optimally annotated, auto-tracked segmentation masks as a strategy to address data scarcity and improve performance. Our results demonstrate the efficacy of real-world training data in countering the main challenge reported by prior works, the trade-off between blood presence and gauze detection. The incorporation of auto-tracked annotations yields performance enhancements, particularly in generic surgical scenarios. The integration of effective segmentation approaches can benefit robot-guided surgical procedures and various downstream applications by providing precise delineation of foreign objects, thereby enhancing patient safety and surgical outcomes.