Purpose: Artificial intelligence is transforming surgical practices by improving procedural quality and decision-making. Machine learning-based video analysis can reliably identify surgical milestones, enhancing contextual understanding for surgeons. This study proposes a novel framework for detecting critical view of safety (CVS) in robot-assisted laparoscopic cholecystectomy (RLC) to improve procedural safety.
Methods: We present a meta-auxiliary learning framework that delicately combines milestone recognition and anatomical segmentation to enhance contextual awareness. The framework addresses label imbalance by facilitating knowledge sharing across tasks, ensuring balanced optimization. A curated RLC dataset was utilized to evaluate CVS identification and multi-instance segmentation performance.
Results: The proposed method achieved an F1 score of 78% for CVS detection and a mean IOU of 83.9% for anatomical segmentation, demonstrating its efficacy in complex surgical environments.
Conclusion: This framework establishes a new paradigm for surgical video analysis by integrating milestone detection and segmentation. Its ability to enhance decision support and procedural review in RLC highlights its potential for broader adoption in clinical practice.
Keywords: Anatomy segmentation; Clinical milestone; Machine learning; Meta-auxiliary learning; Vision transformer.
© 2025. The Author(s).