Evidence map›Paper›PMID 35171336›Full record

ArticleSurgical endoscopy2022

Multicentric validation of EndoDigest: a computer vision platform for video documentation of the critical view of safety in laparoscopic cholecystectomy.

Pietro Mascagni, Deepak Alapatt, Giovanni Guglielmo Laracca, Ludovica Guerriero, Andrea Spota, Claudio Fiorillo, Armine Vardazaryan, Giuseppe Quero, Sergio Alfieri, Ludovica Baldari and 6 more

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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
5.2field-weighted citation impact, top 4% of its field
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

20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
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  4. Review
  5. GEN-Guard: correcting generalization failures for deployable federated surgical AI.International journal of computer assisted radiology and surgery · 2026
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  15. Challenges in multi-centric generalization: phase and step recognition in Roux-en-Y gastric bypass surgery.International journal of computer assisted radiology and surgery · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 2 countries.

Pietro Mascagni *ICube, University of Strasbourg, CNRS, c/o IHU-Strasbourg, 1, place de l'hôpital, 67000, Strasbourg, France. p.mascagni@unistra.fr.ORCID http://orcid.org/0000-0001-7288-3023
Deepak Alapatt *ICube, University of Strasbourg, CNRS, c/o IHU-Strasbourg, 1, place de l'hôpital, 67000, Strasbourg, France.
Giovanni Guglielmo LaraccaDepartment of Medical Surgical Science and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Ludovica GuerrieroDepartment of Laparoscopic and Robotic General Surgery, Monaldi Hospital, AORN dei Colli, Naples, Italy.
Andrea SpotaScuola di Specializzazione in Chirurgia Generale, University of Milan, Milan, Italy.
Claudio FiorilloFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Armine VardazaryanICube, University of Strasbourg, CNRS, c/o IHU-Strasbourg, 1, place de l'hôpital, 67000, Strasbourg, France.
Giuseppe QueroFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Sergio AlfieriFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Ludovica BaldariDepartment of Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy.
Elisa CassinottiDepartment of Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy.
Luigi BoniDepartment of Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy.
Diego CuccurulloDepartment of Laparoscopic and Robotic General Surgery, Monaldi Hospital, AORN dei Colli, Naples, Italy.
Guido CostamagnaFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Bernard DallemagneInstitute for Research Against Digestive Cancer (IRCAD), Strasbourg, France.
Nicolas PadoyICube, University of Strasbourg, CNRS, c/o IHU-Strasbourg, 1, place de l'hôpital, 67000, Strasbourg, France.
Agostino Gemelli University Polyclinic · ITCentre National de la Recherche Scientifique · FRUniversity of Milan · ITOspedale Monaldi · ITInstitut de Recherche contre les Cancers de l’Appareil Digestif · FRSapienza University of Rome · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA computer vision (CV) platform named EndoDigest was recently developed to facilitate the use of surgical videos. Specifically, EndoDigest automatically provides short video clips to effectively document the critical view of safety (CVS) in laparoscopic cholecystectomy (LC). The aim of the present study is to validate EndoDigest on a multicentric dataset of LC videos.

methodsLC videos from 4 centers were manually annotated with the time of the cystic duct division and an assessment of CVS criteria. Incomplete recordings, bailout procedures and procedures with an intraoperative cholangiogram were excluded. EndoDigest leveraged predictions of deep learning models for workflow analysis in a rule-based inference system designed to estimate the time of the cystic duct division. Performance was assessed by computing the error in estimating the manually annotated time of the cystic duct division. To provide concise video documentation of CVS, EndoDigest extracted video clips showing the 2 min preceding and the 30 s following the predicted cystic duct division. The relevance of the documentation was evaluated by assessing CVS in automatically extracted 2.5-min-long video clips.

results144 of the 174 LC videos from 4 centers were analyzed. EndoDigest located the time of the cystic duct division with a mean error of 124.0 ± 270.6 s despite the use of fluorescent cholangiography in 27 procedures and great variations in surgical workflows across centers. The surgical evaluation found that 108 (75.0%) of the automatically extracted short video clips documented CVS effectively.

conclusionsEndoDigest was robust enough to reliably locate the time of the cystic duct division and efficiently video document CVS despite the highly variable workflows. Training specifically on data from each center could improve results; however, this multicentric validation shows the potential for clinical translation of this surgical data science tool to efficiently document surgical safety.

Indexed as

Cholecystectomy, LaparoscopicCholangiographyComputersDocumentationHumansVideo RecordingComputer visionCritical view of safetyLaparoscopic cholecystectomyMulticentric validationSurgical data scienceVideo-based assessment

Identifiers

PMID35171336
OpenAlexW4212811578

What OpenQuestion holds

Textmetadata
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Registered trials

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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.