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Next-generation surgical navigation: Marker-less multi-view 6DoF pose estimation of surgical instruments

Jonas Hein, Nicola Cavalcanti, D. Suter, Lukas Zingg, Fabio Carrillo, Lilian Calvet, Mazda Farshad, Nassir Navab, Marc Pollefeys, Philipp Fürnstahl

2025Medical Image Analysis13 citationsDOIOpen Access PDF

Abstract

State-of-the-art research of traditional computer vision is increasingly leveraged in the surgical domain. A particular focus in computer-assisted surgery is to replace marker-based tracking systems for instrument localization with pure image-based 6DoF pose estimation using deep-learning methods. However, state-of-the-art single-view pose estimation methods do not yet meet the accuracy required for surgical navigation. In this context, we investigate the benefits of multi-view setups for highly accurate and occlusion-robust 6DoF pose estimation of surgical instruments and derive recommendations for an ideal camera system that addresses the challenges in the operating room. Our contributions are threefold. First, we present a multi-view RGB-D video dataset of ex-vivo spine surgeries, captured with static and head-mounted cameras and including rich annotations for surgeon, instruments, and patient anatomy. Second, we perform an extensive evaluation of three state-of-the-art single-view and multi-view pose estimation methods, analyzing the impact of camera quantities and positioning, limited real-world data, and static, hybrid, or fully mobile camera setups on the pose accuracy, occlusion robustness, and generalizability. Third, we design a multi-camera system for marker-less surgical instrument tracking, achieving an average position error of 1.01mm and orientation error of 0.89° for a surgical drill, and 2.79mm and 3.33° for a screwdriver under optimal conditions. Our results demonstrate that marker-less tracking of surgical instruments is becoming a feasible alternative to existing marker-based systems.

Topics & Concepts

PoseArtificial intelligenceComputer visionComputer scienceSurgical robotEstimationSurgical instrumentMedicineSurgeryRobotEngineeringSystems engineeringAnatomy and Medical TechnologySurgical Simulation and TrainingAugmented Reality Applications
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