Deep neural networks are prone to learning spurious correlations, exploiting dataset-specific artifacts rather than meaningful features for prediction. In surgical operating rooms (OR), these manifest through the standardization of smocks and gowns that obscure robust identifying landmarks, introducing model bias for tasks related to modeling OR personnel. Through gradient-based saliency analysis on two public OR datasets, we reveal that CNN models succumb to such shortcuts, fixating on incidental visual cues such as footwear beneath surgical gowns, distinctive eyewear, or other role-specific identifiers. Avoiding such biases is essential for the next generation of intelligent assistance systems in the OR, which should accurately recognize personalized workflow traits, such as surgical skill level or coordination with other staff members. We address this problem by encoding personnel as 3D point cloud sequences, disentangling identity-relevant shape and motion patterns from appearance-based confounders. Our experiments demonstrate that while RGB and geometric methods achieve comparable performance on datasets with apparent simulation artifacts, RGB models suffer a 12% accuracy drop in realistic clinical settings with decreased visual diversity due to standardizations. This performance gap confirms that geometric representations capture more meaningful biometric features, providing an avenue to developing robust methods of modeling humans in the OR.

Cancer detection and classification from gigapixel whole slide images of stained tissue specimens has recently experienced enormous progress in computational histopathology. The limitation of available pixel-wise annotated scans shifted the focus from tumor localization to global slide-level classification on the basis of (weakly-supervised) multiple-instance learning despite the clinical importance of local cancer detection. However, the worse performance of these techniques in comparison to fully supervised methods has limited their usage until now for diagnostic interventions in domains of life-threatening diseases such as cancer. In this work, we put the focus back on tumor localization in form of a patch-level classification task and take up the setting of so-called coarse annotations, which provide greater training supervision while remaining feasible from a clinical standpoint. To this end, we present a novel ensemble method that not only significantly improves the detection accuracy of metastasis on the open CAMELYON16 data set of sentinel lymph nodes of breast cancer patients, but also considerably increases its robustness against noise while training on coarse annotations. Our experiments show that better results can be achieved with our technique making it clinically feasible to use for cancer diagnosis and opening a new avenue for translational and clinical research.

The surgical operating room (OR) presents many opportunities for automation and optimization. Videos from various sources in the OR are becoming increasingly available. The medical community seeks to leverage this wealth of data to develop automated methods to advance interventional care, lower costs, and improve overall patient outcomes. Existing datasets from OR room cameras are thus far limited in size or modalities acquired, leaving it unclear which sensor modalities are best suited for tasks such as recognizing surgical action from videos. This study demonstrates that surgical action recognition performance can vary depending on the image modalities used. We perform a methodical analysis on several commonly available sensor modalities, presenting two fusion approaches that improve classification performance. The analyses are carried out on a set of multi-view RGB-D video recordings of 18 laparoscopic procedures.

Providing intelligent support to surgical teams is a key frontier in automated surgical scene understanding, with the long-term goal of improving patient outcomes. Developing personalized intelligence for all staff members requires maintaining a consistent state of who is located where for long surgical procedures, which still poses numerous computational challenges. We propose TrackOR, a framework for tackling long-term multi-person tracking and re-identification in the operating room. TrackOR uses 3D geometric signatures to achieve state-of-the-art online tracking performance (+11% Association Accuracy over the strongest baseline), while also enabling an effective offline recovery process to create analysis-ready trajectories. Our work shows that by leveraging 3D geometric information, persistent identity tracking becomes attainable, enabling a critical shift towards the more granular, staff-centric analyses required for personalized intelligent systems in the operating room. This new capability opens up various applications, including our proposed temporal pathway imprints that translate raw tracking data into actionable insights for improving team efficiency and safety and ultimately providing personalized support.