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Updated: May 15, 2025

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Author Spotlight: Revolutionizing Remote Surgery with Augmented Reality and Robotics for Enhanced Precision and Accessibility
Published on: August 9, 2024
593
Automated multimodel segmentation and tracking for AR-guided open liver surgery using scene-aware self-prompting
Serouj Khajarian1,2, Michael Schwimmbeck3, Konstantin Holzapfel4
1Research Group Medical Technologies, University of Applied Sciences Landshut, 84036, Landshut, Germany. serouj.khajarian@haw-landshut.de.
Summary
This study presents a real-time semantic segmentation and tracking system for augmented reality (AR)-guided liver surgery. The approach enhances surgical accuracy and speed by integrating multiple AI models with a novel scene-aware re-prompting strategy.
Area of Science:
- Medical Imaging
- Computer Vision
- Surgical Technology
Background:
- Augmented Reality (AR) integration in surgery requires real-time, accurate visual data processing.
- Open liver surgery presents complex anatomical variations demanding robust segmentation and tracking.
Purpose of the Study:
- To develop a multimodel, real-time semantic segmentation and tracking system for AR-guided open liver surgery.
- To leverage foundation models and scene-aware re-prompting for balancing accuracy and speed in surgical AR applications.
Main Methods:
- Integrated ESANet (RGBD model), SAM (segmentation foundation model), and DeAOT (video object segmentation).
- Developed an auto-promptable pipeline with a scene-aware re-prompting algorithm adapting to surgical scene changes.
- Evaluated on intraoperative RGBD videos from 10 open liver surgeries using a head-mounted AR device.
Main Results:
- The multimodel approach achieved 71% median IoU at 13.2 FPS without re-prompting.
- Outperformed individual models, offering superior segmentation accuracy over ESANet and better temporal resolution than SAM.
- Scene-aware re-prompting reached 74.7% IoU at 11.5 FPS, matching DeAOT's performance.
Conclusions:
- The scene-aware re-prompting strategy effectively balances segmentation accuracy and temporal resolution for real-time AR liver surgery.
- Integrating complementary models ensures robust and accurate segmentation in complex surgical environments.

