Evidence map›Paper›PMID 30443889›Full record

ArticleInternational journal of computer assisted radiology and surgery2019

"Deep-Onto" network for surgical workflow and context recognition.

Hirenkumar Nakawala, Roberto Bianchi, Laura Erica Pescatori, Ottavio De Cobelli, Giancarlo Ferrigno, Elena De Momi

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In one paragraph

Article in International journal of computer assisted radiology and surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Semantic segmentation dataset authoring with simplified labels.International journal of computer assisted radiology and surgery · 2025
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  5. Review
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  11. Evaluation of single-stage vision models for pose estimation of surgical instruments.International journal of computer assisted radiology and surgery · 2023
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  12. Review
  13. Surgical workflow recognition with temporal convolution and transformer for action segmentation.International journal of computer assisted radiology and surgery · 2023
    Article
  14. Article
  15. Review
  16. Concepts and Trends n Autonomy for Robot-Assisted Surgery.Proceedings of the IEEE. Institute of Electrical and Electronics Engineers · 2022
    Article
  17. Review
  18. Review
  19. Article
  20. Surgical workflow recognition with 3DCNN for Sleeve Gastrectomy.International journal of computer assisted radiology and surgery · 2021
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Hirenkumar NakawalaDepartment of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy. hirenkumar.nakawala@polimi.it.
Roberto BianchiDepartment of Urology, European Institute of Oncology (IEO), Via Giuseppe Ripamonti, 435, 20141, Milan, Italy.
Laura Erica PescatoriDepartment of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
Ottavio De CobelliDepartment of Urology, European Institute of Oncology (IEO), Via Giuseppe Ripamonti, 435, 20141, Milan, Italy.
Giancarlo FerrignoDepartment of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
Elena De MomiDepartment of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.

Funding

Horizon 2020 Framework Programme () H2020-ICT-2016-732515
6 · The paper itself

Abstract

purposeSurgical workflow recognition and context-aware systems could allow better decision making and surgical planning by providing the focused information, which may eventually enhance surgical outcomes. While current developments in computer-assisted surgical systems are mostly focused on recognizing surgical phases, they lack recognition of surgical workflow sequence and other contextual element, e.g., "Instruments." Our study proposes a hybrid approach, i.e., using deep learning and knowledge representation, to facilitate recognition of the surgical workflow.

methodsWe implemented "Deep-Onto" network, which is an ensemble of deep learning models and knowledge management tools, ontology and production rules. As a prototypical scenario, we chose robot-assisted partial nephrectomy (RAPN). We annotated RAPN videos with surgical entities, e.g., "Step" and so forth. We performed different experiments, including the inter-subject variability, to recognize surgical steps. The corresponding subsequent steps along with other surgical contexts, i.e., "Actions," "Phase" and "Instruments," were also recognized.

resultsThe system was able to recognize 10 RAPN steps with the prevalence-weighted macro-average (PWMA) recall of 0.83, PWMA precision of 0.74, PWMA F1 score of 0.76, and the accuracy of 74.29% on 9 videos of RAPN.

conclusionWe found that the combined use of deep learning and knowledge representation techniques is a promising approach for the multi-level recognition of RAPN surgical workflow.

Indexed as

Deep LearningWorkflowHumansKidney NeoplasmsNephrectomyRobotic Surgical ProceduresDeep learningKnowledge representationRobot-assisted partial nephrectomySurgical workflow

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.