Abstract-Surgical workflow recognition has numerous potential medical applications, such as the automatic indexing of surgical video databases and the optimization of real-time operating room scheduling, among others. As a result, phase recognition has been studied in the context of several kinds of surgeries, such as cataract, neurological, and laparoscopic surgeries. In the literature, two types of features are typically used to perform this task: visual features and tool usage signals. However, the visual features used are mostly handcrafted. Furthermore, the tool usage signals are usually collected via a manual annotation process or by using additional equipment. In this paper, we propose a novel method for phase recognition that uses a convolutional neural network (CNN) to automatically learn features from cholecystectomy videos and that relies uniquely on visual information. In previous studies, it has been shown that the tool usage signals can provide valuable information in performing the phase recognition task. Thus, we present a novel CNN architecture, called EndoNet, that is designed to carry out the phase recognition and tool presence detection tasks in a multi-task manner. To the best of our knowledge, this is the first work proposing to use a CNN for multiple recognition tasks on laparoscopic videos. Extensive experimental comparisons to other methods show that EndoNet yields state-of-the-art results for both tasks.

Abstract-This paper presents a predictive control approach to active mechanical filtering of complex, periodic motions of organs induced by respiration or heart beating in robotized surgery. Two different predictive control schemes are proposed for the compensation of respiratory motions or cardiac motions.For respiratory motions, the periodic property of the disturbance has been included into the input-output model of the controlled system so as to have the robotic system learn and anticipate perturbation motions. A new cost function is proposed for the unconstrained generalized predictive controller (GPC) where reference tracking is decoupled from the rejection of predictable periodic motions.Cardiac motions are more complex since they are the combination of two periodic non-harmonic components. An adaptive disturbance predictor is proposed which outputs future predicted disturbance values. These predicted values are used to anticipate the disturbance by using the predictive feature of a regular GPC.Experimental results are presented on a laboratory testbed and in vivo on pigs. They demonstrate the effectiveness of the two proposed methods to compensate complex physiological motion.

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The concepts developed for STRAS are validated and could bring new tools for surgeons to improve comfort, ease, and performances for intraluminal surgical endoscopy.

Percutaneous procedures are among the developing minimally invasive techniques to treat cancerous diseases of the digestive system. They require a very accurate targeting of the organs, achieved by the combination of tactile sensing and medical imaging. In this paper, we study the forces involved during in vivo percutaneous procedures for the development of a force feedback needle insertion robotic system as well as the development of a realistic simulation device. The paper presents different conditions (manual and robotic insertions) and different organs (liver and kidney). Finally, we review some bio-mechanical models of the literature in the light of our measurements.

Femoral neck fracture puts at risk functional prognosis in young patients and can be life-threatening in the elderly. The present study reviews methods of femoral head vascularity assessment following neck fracture, to address the following issues: what is the risk of osteonecrosis? And what, in the light of this risk, is the best-adapted treatment to avoid iterative surgery? Femoral head vascularity depends on retinacular vessels and especially the lateral epiphyseal artery, which contributes from 70 to 80% of the femoral head vascular supply. Fracture causes vascular lesions, which are in turn the prime cause of necrosis. Other factors combine with this: hematoma tamponade effect, reduced joint space and increased pressure due to lower extremity positioning in extension/internal rotation/abduction during surgery. Head deformity is not due to direct cell death but to the repair process originating from the surrounding living bone. In post-traumatic necrosis, proliferation rapidly invades the head, with significant osteogenesis. Pathologic fractures occur at the boundary between the new and dead bone. Many techniques have been reported to help assess residual hemodynamics and risk of necrosis. Some are invasive: superselective angiography, intra-osseous oxygen pressure measurement, or Doppler-laser hemodynamic measurement; others involve imaging: scintigraphy, conventionnal or dynamic MRI. The future seems to lie with dynamic MRI, which allows a new classification of femoral neck fractures, based on a non-invasive assessment of femoral head vascularity.

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