Related Experiment Video
Updated: Nov 2, 2025
Technical Approach for Infrared Tracking for Soft Tissue Navigation with a Holographic Head-Mounted Display and Preclinical Validation
Published on: September 2, 2025
Machine Vision for Real-Time Intraoperative Anatomic Guidance: A Proof-of-Concept Study in Endoscopic Pituitary
Victor E Staartjes1, Anna Volokitin2, Luca Regli1
1Machine Intelligence in Clinical Neuroscience (MICN) Laboratory, Department of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Centre, University of Zurich, Zurich, Switzerland.
Background:
Current intraoperative orientation methods either rely on preoperative imaging, are resource-intensive to implement, or difficult to interpret. Real-time, reliable anatomic recognition would constitute another strong pillar on which neurosurgeons could rest for intraoperative orientation.
Objective:
To assess the feasibility of machine vision algorithms to identify anatomic structures using only the endoscopic camera without prior explicit anatomo-topographic knowledge in a proof-of-concept study.
Methods:
We developed and validated a deep learning algorithm to detect the nasal septum, the middle turbinate, and the inferior turbinate during endoscopic endonasal approaches based on endoscopy videos from 23 different patients. The model was trained in a weakly supervised manner on 18 and validated on 5 patients. Performance was compared against a baseline consisting of the average positions of the training ground truth labels using a semiquantitative 3-tiered system.
Results:
We used 367 images extracted from the videos of 18 patients for training, as well as 182 test images extracted from the videos of another 5 patients for testing the fully developed model. The prototype machine vision algorithm was able to identify the 3 endonasal structures qualitatively well. Compared to the baseline model based on location priors, the algorithm demonstrated slightly but statistically significantly (P < .001) improved annotation performance.
Conclusion:
Automated recognition of anatomic structures in endoscopic videos by means of a machine vision model using only the endoscopic camera without prior explicit anatomo-topographic knowledge is feasible. This proof of concept encourages further development of fully automated software for real-time intraoperative anatomic guidance during surgery.
