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De Backer P, Simoens J, Mestdagh K, Hofman J, Eckhoff JA, Jobczyk M, Van Eetvelde E, D’Hondt M, Moschovas MC, Patel V, Van Praet C, Fuchs HF, Debbaut C, Decaestecker K, Mottrie A. Privacy-proof Live Surgery Streaming: Development and Validation of a Low-cost, Real-time Robotic Surgery Anonymization Algorithm. Ann Surg 2024; 280:13-20. [PMID: 38390732 PMCID: PMC11161223 DOI: 10.1097/sla.0000000000006245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Develop a pioneer surgical anonymization algorithm for reliable and accurate real-time removal of out-of-body images validated across various robotic platforms. BACKGROUND The use of surgical video data has become a common practice in enhancing research and training. Video sharing requires complete anonymization, which, in the case of endoscopic surgery, entails the removal of all nonsurgical video frames where the endoscope can record the patient or operating room staff. To date, no openly available algorithmic solution for surgical anonymization offers reliable real-time anonymization for video streaming, which is also robotic-platform and procedure-independent. METHODS A data set of 63 surgical videos of 6 procedures performed on four robotic systems was annotated for out-of-body sequences. The resulting 496.828 images were used to develop a deep learning algorithm that automatically detected out-of-body frames. Our solution was subsequently benchmarked against existing anonymization methods. In addition, we offer a postprocessing step to enhance the performance and test a low-cost setup for real-time anonymization during live surgery streaming. RESULTS Framewise anonymization yielded a receiver operating characteristic area under the curve score of 99.46% on unseen procedures, increasing to 99.89% after postprocessing. Our Robotic Anonymization Network outperforms previous state-of-the-art algorithms, even on unseen procedural types, despite the fact that alternative solutions are explicitly trained using these procedures. CONCLUSIONS Our deep learning model, Robotic Anonymization Network, offers reliable, accurate, and safe real-time anonymization during complex and lengthy surgical procedures regardless of the robotic platform. The model can be used in real time for surgical live streaming and is openly available.
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Affiliation(s)
- Pieter De Backer
- ORSI Academy, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Belgium
- IBiTech-Biommeda, Faculty of Engineering and Architecture, CRIG, Ghent University, Belgium
- Urology Department, Ghent University Hospital, Belgium
| | | | - Kenzo Mestdagh
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | | | - Jennifer A. Eckhoff
- Robotic Innovation Laboratory, Department of General, University Hospital Cologne, Visceral, Tumor and Transplantsurgery, Germany
| | - Mateusz Jobczyk
- Urology Department, Salve Medica Hospital Lodz, Lodz, Poland
| | | | - Mathieu D’Hondt
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, AZ Groeninge Hospital Kortrijk, Belgium
| | | | - Vipul Patel
- Urology Department, AdventHealth Global Robotics Institute, Celebration, FL
| | | | - Hans F. Fuchs
- Robotic Innovation Laboratory, Department of General, University Hospital Cologne, Visceral, Tumor and Transplantsurgery, Germany
| | - Charlotte Debbaut
- IBiTech-Biommeda, Faculty of Engineering and Architecture, CRIG, Ghent University, Belgium
| | - Karel Decaestecker
- Urology Department, Ghent University Hospital, Belgium
- Urology Department, AZ Maria Middelares Hospital Ghent, Ghent, Belgium
| | - Alexandre Mottrie
- ORSI Academy, Belgium
- Urology Department, OLV Hospital Aalst-Asse-Ninove, Belgium
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De Backer P, Nickel F. Role of robotics as a key platform for digital advancements in surgery. Br J Surg 2024; 111:znae064. [PMID: 38573332 DOI: 10.1093/bjs/znae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Affiliation(s)
- Pieter De Backer
- ORSI Academy asl, Mellle, Oost-Vlaanderen, Belgium
- Department of Urology, UZ Gent, Gent, Oost-Vlaanderen, Belgium
| | - Felix Nickel
- General, Visceral and Transplantation Surgery, University of Heidelberg Hospital, Heidelberg, Germany
- General, Visceral, Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Yiu A, Lam K, Simister C, Clarke J, Kinross J. Adoption of routine surgical video recording: a nationwide freedom of information act request across England and Wales. EClinicalMedicine 2024; 70:102545. [PMID: 38685926 PMCID: PMC11056472 DOI: 10.1016/j.eclinm.2024.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 05/02/2024] Open
Abstract
Background Surgical video contains data with significant potential to improve surgical outcome assessment, quality assurance, education, and research. Current utilisation of surgical video recording is unknown and related policies/governance structures are unclear. Methods A nationwide Freedom of Information (FOI) request concerning surgical video recording, technology, consent, access, and governance was sent to all acute National Health Service (NHS) trusts/boards in England/Wales between 20th February and 20th March 2023. Findings 140/144 (97.2%) trusts/boards in England/Wales responded to the FOI request. Surgical procedures were routinely recorded in 22 trusts/boards. The median estimate of consultant surgeons routinely recording their procedures was 20%. Surgical video was stored on internal systems (n = 27), third-party products (n = 29), and both (n = 9). 32/140 (22.9%) trusts/boards ask for consent to record procedures as part of routine care. Consent for recording included non-clinical purposes in 55/140 (39.3%) trusts/boards. Policies for surgeon/patient access to surgical video were available in 48/140 (34.3%) and 32/140 (22.9%) trusts/boards, respectively. Surgical video was used for non-clinical purposes in 64/140 (45.7%) trusts/boards. Governance policies covering surgical video recording, use, and/or storage were available from 59/140 (42.1%) trusts/boards. Interpretation There is significant heterogeneity in surgical video recording practices in England and Wales. A minority of trusts/boards routinely record surgical procedures, with large variation in recording/storage practices indicating scope for NHS-wide coordination. Revision of surgical video consent, accessibility, and governance policies should be prioritised by trusts/boards to protect key stakeholders. Increased availability of surgical video is essential for patients and surgeons to maximally benefit from the ongoing digital transformation of surgery. Funding KL is supported by an NIHR Academic Clinical Fellowship and acknowledges infrastructure support for this research from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC).
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Affiliation(s)
- Andrew Yiu
- Department of Surgery and Cancer, Imperial College London, UK
| | - Kyle Lam
- Department of Surgery and Cancer, Imperial College London, UK
| | | | - Jonathan Clarke
- Department of Surgery and Cancer, Imperial College London, UK
| | - James Kinross
- Department of Surgery and Cancer, Imperial College London, UK
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Gabryel P, Skrzypczak P, Roszak M, Campisi A, Zielińska D, Bryl M, Stencel K, Piwkowski C. Influencing Factors on the Quality of Lymph Node Dissection for Stage IA Non-Small Cell Lung Cancer: A Retrospective Nationwide Cohort Study. Cancers (Basel) 2024; 16:346. [PMID: 38254835 PMCID: PMC10814584 DOI: 10.3390/cancers16020346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Lymphadenectomy is an essential part of complete surgical operation for non-small cell lung cancer (NSCLC). This retrospective, multicenter cohort study aimed to identify factors that influence the lymphadenectomy quality. Data were obtained from the Polish Lung Cancer Study Group Database. The primary endpoint was lobe-specific mediastinal lymph node dissection (L-SMLND). The study included 4271 patients who underwent VATS lobectomy for stage IA NSCLC, operated between 2007 and 2022. L-SMLND was performed in 1190 patients (27.9%). The remaining 3081 patients (72.1%) did not meet the L-SMLND criteria. Multivariate logistic regression analysis showed that patients with PET-CT (OR 3.238, 95% CI: 2.315 to 4.529; p < 0.001), with larger tumors (pT1a vs. pT1b vs. pT1c) (OR 1.292; 95% CI: 1.009 to 1.653; p = 0.042), and those operated on by experienced surgeons (OR 1.959, 95% CI: 1.432 to 2.679; p < 0.001) had a higher probability of undergoing L-SMLND. The quality of lymphadenectomy decreased over time (OR 0.647, 95% CI: 0.474 to 0.884; p = 0.006). An analysis of propensity-matched groups showed that more extensive lymph node dissection was not related to in-hospital mortality, complication rates, and hospitalization duration. Actions are needed to improve the quality of lymphadenectomy for NSCLC.
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Affiliation(s)
- Piotr Gabryel
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
| | - Piotr Skrzypczak
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Rokietnicka 7 Street, 60-806 Poznan, Poland
| | - Alessio Campisi
- Department of Thoracic Surgery, University and Hospital Trust–Ospedale Borgo Trento, Piazzale Aristide Stefani 1, 37126 Verona, Italy
| | - Dominika Zielińska
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
| | - Maciej Bryl
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
| | - Katarzyna Stencel
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
| | - Cezary Piwkowski
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
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Eckhoff JA, Meireles O. Could Artificial Intelligence guide surgeons' hands? Rev Col Bras Cir 2023; 50:e20233696EDIT01. [PMID: 38088637 PMCID: PMC10668586 DOI: 10.1590/0100-6991e-20233696edit01-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- Jennifer A. Eckhoff
- - Harvard Medical School, Surgical Artificial Intelligence and Innovation Laboratory, Massachusetts General Hospital - Boston - MA - Estados Unidos
| | - Ozanan Meireles
- - Harvard Medical School, Surgical Artificial Intelligence and Innovation Laboratory, Massachusetts General Hospital - Boston - MA - Estados Unidos
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De Backer P, Peraire Lores M, Demuynck M, Piramide F, Simoens J, Oosterlinck T, Bogaert W, Shan CV, Van Regemorter K, Wastyn A, Checcucci E, Debbaut C, Van Praet C, Farinha R, De Groote R, Gallagher A, Decaestecker K, Mottrie A. Surgical Phase Duration in Robot-Assisted Partial Nephrectomy: A Surgical Data Science Exploration for Clinical Relevance. Diagnostics (Basel) 2023; 13:3386. [PMID: 37958283 PMCID: PMC10650909 DOI: 10.3390/diagnostics13213386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
(1) Background: Surgical phases form the basic building blocks for surgical skill assessment, feedback, and teaching. The phase duration itself and its correlation with clinical parameters at diagnosis have not yet been investigated. Novel commercial platforms provide phase indications but have not been assessed for accuracy yet. (2) Methods: We assessed 100 robot-assisted partial nephrectomy videos for phase durations based on previously defined proficiency metrics. We developed an annotation framework and subsequently compared our annotations to an existing commercial solution (Touch Surgery, Medtronic™). We subsequently explored clinical correlations between phase durations and parameters derived from diagnosis and treatment. (3) Results: An objective and uniform phase assessment requires precise definitions derived from an iterative revision process. A comparison to a commercial solution shows large differences in definitions across phases. BMI and the duration of renal tumor identification are positively correlated, as are tumor complexity and both tumor excision and renorrhaphy duration. (4) Conclusions: The surgical phase duration can be correlated with certain clinical outcomes. Further research should investigate whether the retrieved correlations are also clinically meaningful. This requires an increase in dataset sizes and facilitation through intelligent computer vision algorithms. Commercial platforms can facilitate this dataset expansion and help unlock the full potential, provided that the phase annotation details are disclosed.
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Affiliation(s)
- Pieter De Backer
- ORSI Academy, 9090 Melle, Belgium
- IbiTech-Biommeda, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium (C.V.P.)
- Young Academic Urologist—Urotechnology Working Group, NL-6803 Arnhem, The Netherlands
- Department of Urology, ERN eUROGEN Accredited Centre, Ghent University Hospital, 9000 Ghent, Belgium
| | | | - Meret Demuynck
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium (C.V.P.)
| | - Federico Piramide
- ORSI Academy, 9090 Melle, Belgium
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy
| | | | | | - Wouter Bogaert
- IbiTech-Biommeda, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
| | - Chi Victor Shan
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium (C.V.P.)
| | - Karel Van Regemorter
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium (C.V.P.)
| | - Aube Wastyn
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium (C.V.P.)
| | - Enrico Checcucci
- Young Academic Urologist—Urotechnology Working Group, NL-6803 Arnhem, The Netherlands
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy
| | - Charlotte Debbaut
- IbiTech-Biommeda, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
| | - Charles Van Praet
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium (C.V.P.)
- Department of Urology, ERN eUROGEN Accredited Centre, Ghent University Hospital, 9000 Ghent, Belgium
| | | | - Ruben De Groote
- Department of Urology, Onze-Lieve Vrouwziekenhuis Hospital, 9300 Aalst, Belgium
| | | | - Karel Decaestecker
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium (C.V.P.)
- Department of Urology, ERN eUROGEN Accredited Centre, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Urology, AZ Maria Middelares Hospital, 9000 Ghent, Belgium
| | - Alexandre Mottrie
- ORSI Academy, 9090 Melle, Belgium
- Department of Urology, Onze-Lieve Vrouwziekenhuis Hospital, 9300 Aalst, Belgium
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