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Alexander C. Jenke

Publications and source records attributed to Alexander C. Jenke.

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Federated EndoViT: Pretraining Vision Transformers via Federated Learning on Endoscopic Image Collections

Purpose: Data privacy regulations hinder the creation of generalizable foundation models (FMs) for surgery by preventing multi-institutional data aggregation. This study investigates federated learning (FL) as a privacy-preserving solution to collaboratively train robust surgical FMs. Methods: We introduce Federated EndoViT (FL-EndoViT), a federated framework that validates the Masked Autoencoder (MAE) pretraining strategy in a decentralized surgical setting. To ensure convergence under severe data heterogeneity, the architecture integrates adaptive Sharpness-Aware Minimization (FedSAM). Pretrained on the large-scale Endo700k dataset, FL-EndoViT is evaluated against a centralized baseline on different tasks including scene segmentation, action recognition, and phase recognition. Results: FedSAM is critical for successful pretraining, overcoming the convergence failures of standard federated methods. The resulting FL-EndoViT performs comparably to its centralized counterpart, with significant advantages in data-scarce, high-resolution segmentation and generalization to new surgical events. We also establish that full, end-to-end fine-tuning is necessary for optimal performance. Conclusion: This work validates FL with adaptive optimization as a viable paradigm for creating robust, privacy-preserving surgical FMs. Our findings provide a scalable framework for collaborative Surgical Data Science and underscore the optimizer's critical role in handling data heterogeneity. Future work should explore video-based models to incorporate spatiotemporal dynamics.

cs.CV

XiCAD: Camera Activation Detection in the Da Vinci Xi User Interface

Purpose: Robot-assisted minimally invasive surgery relies on endoscopic video as the sole intraoperative visual feedback. The DaVinci Xi system overlays a graphical user interface (UI) that indicates the state of each robotic arm, including the activation of the endoscope arm. Detecting this activation provides valuable metadata such as camera movement information, which can support downstream surgical data science tasks including tool tracking, skill assessment, or camera control automation. Methods: We developed a lightweight pipeline based on a ResNet18 convolutional neural network to automatically identify the position of the camera tile and its activation state within the DaVinci Xi UI. The model was fine-tuned on manually annotated data from the SurgToolLoc dataset and evaluated across three public datasets comprising over 70,000 frames. Results: The model achieved F1-scores between 0.993 and 1.000 for the binary detection of active cameras and correctly localized the camera tile in all cases without false multiple-camera detections. Conclusion: The proposed pipeline enables reliable, real-time extraction of camera activation metadata from surgical videos, facilitating automated preprocessing and analysis for diverse downstream applications. All code, trained models, and annotations are publicly available.

cs.CV

Federated Learning for Surgical Vision in Appendicitis Classification: Results of the FedSurg EndoVis 2024 Challenge

Developing generalizable surgical AI requires multi-institutional data, yet privacy constraints preclude direct data sharing, making Federated Learning (FL) a natural candidate. Its application to complex, spatiotemporal surgical video remains largely unbenchmarked. We present the FedSurg Challenge, the first international initiative dedicated to FL in surgical vision, as a proof-of-concept evaluation using a multi-center dataset of laparoscopic appendectomies (subset of Appendix300). Three participant submissions were evaluated on generalization to an unseen clinical center and center-specific local adaptation, alongside centralized, Swarm Learning, parameter-efficient fine-tuning baselines, and reference classifiers. Our analysis identifies temporal modeling as the architectural factor most consistently associated with generalization to the unseen center, although effects vary across metrics. Classifier collapse arises from both the global model's failure to transfer under domain shift and unconstrained fine-tuning on small, imbalanced local datasets, motivating structured personalized FL for center-specific adaptation. Absolute performance remains far from clinical viability: even with all data pooled centrally, the task reached a 26.31% F1-score on the unseen center. Paired permutation tests resolve only large differences, and no adaptation comparison reaches significance at this sample size. By characterizing these limitations, this work establishes a methodological reference point for privacy-preserving surgical video AI.

cs.CV

One model to use them all: Training a segmentation model with complementary datasets

Understanding a surgical scene is crucial for computer-assisted surgery systems to provide any intelligent assistance functionality. One way of achieving this scene understanding is via scene segmentation, where every pixel of a frame is classified and therefore identifies the visible structures and tissues. Progress on fully segmenting surgical scenes has been made using machine learning. However, such models require large amounts of annotated training data, containing examples of all relevant object classes. Such fully annotated datasets are hard to create, as every pixel in a frame needs to be annotated by medical experts and, therefore, are rarely available. In this work, we propose a method to combine multiple partially annotated datasets, which provide complementary annotations, into one model, enabling better scene segmentation and the use of multiple readily available datasets. Our method aims to combine available data with complementary labels by leveraging mutual exclusive properties to maximize information. Specifically, we propose to use positive annotations of other classes as negative samples and to exclude background pixels of binary annotations, as we cannot tell if they contain a class not annotated but predicted by the model. We evaluate our method by training a DeepLabV3 on the publicly available Dresden Surgical Anatomy Dataset, which provides multiple subsets of binary segmented anatomical structures. Our approach successfully combines 6 classes into one model, increasing the overall Dice Score by 4.4% compared to an ensemble of models trained on the classes individually. By including information on multiple classes, we were able to reduce confusion between stomach and colon by 24%. Our results demonstrate the feasibility of training a model on multiple datasets. This paves the way for future work further alleviating the need for one large, fully segmented datasets.

cs.CV