arXiv subjects

Martin Wagner

Publications and source records attributed to Martin Wagner.

At least 19 recordsLinked to original sources

arXiv2026

MISTac: A Vision-Based Tactile Sensor for Minimally Invasive Surgery

Minimally invasive and robot-assisted surgery offer many advantages over traditional open surgery, but deprive surgeons of tactile feedback and the ability to palpate tissue with their fingers. To address this lack of tactile feedback, we introduce the MISTac, a high resolution vision-based tactile sensor specifically designed for palpation in MIS. The sensor has a replaceable sensor tip with a diameter of 8 mm which allows it to fit through the trocars used in minimally invasive surgery. Its modular 3D-printed case design allows the use of bulky off-the-shelf illumination and imaging hardware that can easily be exchanged and upgraded. The sensor has an optical resolution of 176.68 $\mu m$, a tactile resolution of 250 $\mu m$, and can resolve forces as little as 24.3 mN. An in vivo study with the sensor shows its usability in minimally invasive surgery. We trained a machine learning model with the tactile data collected in the trial on a tissue classification task achieving an aggregate accuracy of ~84% in a leave-one-out cross validation. Tactile sensors have the potential to one day aid surgeons during minimally invasive surgery with tasks such as tissue classification or intra-operative tumor localization; MISTac is a small step towards this vision. We open-source MISTac at https://github.com/lasr-lab/mistac

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arXiv2026

Point Cloud Segmentation for Autonomous Clip Positioning in Laparoscopic Cholecystectomy on a Phantom

High-risk applications in robotics, such as robot-assisted surgery, present unique challenges. These systems must be both highly precise and interpretable in order to be deployed in environments with very low tolerance for error or unsafe exploration. We present the first robotic system to demonstrate autonomous clip positioning on a physical phantom in laparoscopic surgery, one of the most common interventions in general surgery. After segmentation of a colorless point cloud from a single camera, target positions for the clips are extracted using spline interpolation, and can then be adjusted by the human operator. The segmentation model is trained on only 60 hand-labeled real point clouds, reflecting data scarcity in the surgical domain. We overcome this with a combination of pre-training on 128,000 synthetic point clouds and two novel data augmentation techniques. The motion of the end-effector to each target is visualized for the operator, satisfying the unique motion constraints of minimally-invasive surgery while ensuring that the robot's actions are verifiable and interpretable. In real robot experiments, our system localizes targets with the required precision of 0.75mm at a 95% success rate and executes autonomous clip positioning with a 100% success rate. We provide insights that are applicable to many other surgical and non-surgical tasks that require identifying and navigating to a precise target. Source code and project page: https://github.com/balazsgyenes/kirurc

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arXiv2026

LAR-MoE: Latent-Aligned Routing for Mixture of Experts in Robotic Imitation Learning

Imitation learning enables robots to acquire manipulation skills from demonstrations, yet deploying a policy across tasks with heterogeneous dynamics remains challenging, as models tend to average over distinct behavioral modes present in the demonstrations. Mixture-of-Experts (MoE) architectures address this by activating specialized subnetworks, but requires meaningful skill decompositions for expert routing. We introduce Latent-Aligned Routing for Mixture of Experts (LAR-MoE), a two-stage framework that decouples unsupervised skill discovery from policy learning. In pre-training, we learn a joint latent representation between observations and future actions through student-teacher co-training. In a post-training stage, the expert routing is regularized to follow the structure of the learned latent space, preventing expert collapse while maintaining parameter efficiency. We evaluate LAR-MoE in simulation and on hardware. On the LIBERO benchmark, our method achieves a 95.2% average success rate with 150M parameters. On a surgical bowel grasping and retraction task, LAR-MoE matches a supervised MoE baseline without requiring any phase annotations, and transfers zero-shot to ex vivo porcine tissue. Our findings suggest that latent-aligned routing provides a principled alternative to supervised skill decomposition, enabling structured expert specialization from unlabeled demonstrations.

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arXiv2026

An Open-Source Robotics Research Platform for Autonomous Laparoscopic Surgery

Autonomous robot-assisted surgery demands reliable, high-precision platforms that strictly adhere to the safety and kinematic constraints of minimally invasive procedures. Existing research platforms, primarily based on the da Vinci Research Kit, suffer from cable-driven mechanical limitations that degrade state-space consistency and hinder the downstream training of reliable autonomous policies. We present an open-source, robot-agnostic Remote Center of Motion (RCM) controller based on a closed-form analytical velocity solver that enforces the trocar constraint deterministically without iterative optimization. The controller operates in Cartesian space, enabling any industrial manipulator to function as a surgical robot. We provide implementations for the UR5e and Franka Emika Panda manipulators, and integrate stereoscopic 3D perception. We integrate the robot control into a full-stack ROS-based surgical robotics platform supporting teleoperation, demonstration recording, and deployment of learned policies via a decoupled server-client architecture. We validate the system on a bowel grasping and retraction task across phantom, ex vivo, and in vivo porcine laparoscopic procedures. RCM deviations remain sub-millimeter across all conditions, and trajectory smoothness metrics (SPARC, LDLJ) are comparable to expert demonstrations from the JIGSAWS benchmark recorded on the da Vinci system. These results demonstrate that the platform provides the precision and robustness required for teleoperation, data collection and autonomous policy deployment in realistic surgical scenarios.

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arXiv2026

The Dresden Dataset for 4D Reconstruction of Non-Rigid Abdominal Surgical Scenes

The D4D Dataset provides paired endoscopic video and high-quality structured-light geometry for evaluating 3D reconstruction of deforming abdominal soft tissue in realistic surgical conditions. Data were acquired from six porcine cadaver sessions using a da Vinci Xi stereo endoscope and a Zivid structured-light camera, registered via optical tracking and manually curated iterative alignment methods. Three sequence types - whole deformations, incremental deformations, and moved-camera clips - probe algorithm robustness to non-rigid motion, deformation magnitude, and out-of-view updates. Each clip provides rectified stereo images, per-frame instrument masks, stereo depth, start/end structured-light point clouds, curated camera poses and camera intrinsics. In postprocessing, ICP and semi-automatic registration techniques are used to register data, and instrument masks are created. The dataset enables quantitative geometric evaluation in both visible and occluded regions, alongside photometric view-synthesis baselines. Comprising over 300,000 frames and 369 point clouds across 98 curated recordings, this resource can serve as a comprehensive benchmark for developing and evaluating non-rigid SLAM, 4D reconstruction, and depth estimation methods.

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arXiv2026

Supervised Mixture-of-Experts for Surgical Grasping and Retraction

Imitation learning has achieved remarkable success in robotic manipulation, yet its application to surgical robotics remains challenging due to data scarcity, constrained workspaces, and the need for an exceptional level of safety and predictability. We present a supervised Mixture-of-Experts (MoE) architecture designed for phase-structured surgical manipulation tasks, which can be added on top of any autonomous policy. Unlike prior surgical robot learning approaches that rely on multi-camera setups or thousands of demonstrations, we show that a lightweight action decoder policy like Action Chunking Transformer (ACT) can learn complex, long-horizon manipulation from less than 150 demonstrations using solely stereo endoscopic images, when equipped with our architecture. We evaluate our approach on the collaborative surgical task of bowel grasping and retraction, where a robot assistant interprets visual cues from a human surgeon, executes targeted grasping on deformable tissue, and performs sustained retraction. Our results show that generalist Vision Language Action models fail to acquire the task entirely, even under standard in-distribution conditions. Furthermore, while standard ACT achieves moderate success in-distribution, adopting a supervised MoE architecture significantly boosts its performance, yielding higher success rates in-distribution and demonstrating superior robustness in out-of-distribution scenarios, including novel grasp locations, reduced illumination, and partial occlusions. Notably, it generalizes to unseen testing viewpoints and also transfers zero-shot to ex vivo porcine tissue without additional training, offering a promising pathway toward in vivo deployment. To support this statement, we present qualitative preliminary results of policy roll-outs during in vivo porcine surgery.

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arXiv2025

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.

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arXiv2025

Current validation practice undermines surgical AI development

Surgical data science (SDS) is rapidly advancing, yet clinical adoption of artificial intelligence (AI) in surgery remains limited, with inadequate validation as an important contributing factor. Existing validation practices often neglect the temporal and hierarchical structure of intraoperative videos, yielding misleading or clinically irrelevant results. We introduce a comprehensive catalogue of validation pitfalls in AI-based surgical video analysis, derived from a multi-stage Delphi process with 92 international experts. Pitfalls span three categories: (1) data, (2) metric selection/configuration, and (3) aggregation and reporting. A systematic review of surgical AI papers reveals that these pitfalls are widespread. Experiments on surgical video datasets show that ignoring temporal and hierarchical data structures can understate uncertainty, obscure critical failure modes, and alter algorithm rankings. To address these shortcomings, we provide consensus-based best practices compiled. Together, this work provides an evidence-based framework for rigorous validation of surgical video analysis algorithms, guiding benchmarking, reporting, regulatory review, and clinical translation.

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arXiv2025

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.

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arXiv2024

Interactive Surgical Liver Phantom for Cholecystectomy Training

Training and prototype development in robot-assisted surgery requires appropriate and safe environments for the execution of surgical procedures. Current dry lab laparoscopy phantoms often lack the ability to mimic complex, interactive surgical tasks. This work presents an interactive surgical phantom for the cholecystectomy. The phantom enables the removal of the gallbladder during cholecystectomy by allowing manipulations and cutting interactions with the synthetic tissue. The force-displacement behavior of the gallbladder is modelled based on retraction demonstrations. The force model is compared to the force model of ex-vivo porcine gallbladders and evaluated on its ability to estimate retraction forces.

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arXiv2024

Sim-To-Real Transfer for Visual Reinforcement Learning of Deformable Object Manipulation for Robot-Assisted Surgery

Automation holds the potential to assist surgeons in robotic interventions, shifting their mental work load from visuomotor control to high level decision making. Reinforcement learning has shown promising results in learning complex visuomotor policies, especially in simulation environments where many samples can be collected at low cost. A core challenge is learning policies in simulation that can be deployed in the real world, thereby overcoming the sim-to-real gap. In this work, we bridge the visual sim-to-real gap with an image-based reinforcement learning pipeline based on pixel-level domain adaptation and demonstrate its effectiveness on an image-based task in deformable object manipulation. We choose a tissue retraction task because of its importance in clinical reality of precise cancer surgery. After training in simulation on domain-translated images, our policy requires no retraining to perform tissue retraction with a 50% success rate on the real robotic system using raw RGB images. Furthermore, our sim-to-real transfer method makes no assumptions on the task itself and requires no paired images. This work introduces the first successful application of visual sim-to-real transfer for robotic manipulation of deformable objects in the surgical field, which represents a notable step towards the clinical translation of cognitive surgical robotics.

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arXiv2023

Why is the winner the best?

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multi-center study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and postprocessing (66%). The "typical" lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work.

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arXiv2023

LapGym -- An Open Source Framework for Reinforcement Learning in Robot-Assisted Laparoscopic Surgery

Recent advances in reinforcement learning (RL) have increased the promise of introducing cognitive assistance and automation to robot-assisted laparoscopic surgery (RALS). However, progress in algorithms and methods depends on the availability of standardized learning environments that represent skills relevant to RALS. We present LapGym, a framework for building RL environments for RALS that models the challenges posed by surgical tasks, and sofa_env, a diverse suite of 12 environments. Motivated by surgical training, these environments are organized into 4 tracks: Spatial Reasoning, Deformable Object Manipulation & Grasping, Dissection, and Thread Manipulation. Each environment is highly parametrizable for increasing difficulty, resulting in a high performance ceiling for new algorithms. We use Proximal Policy Optimization (PPO) to establish a baseline for model-free RL algorithms, investigating the effect of several environment parameters on task difficulty. Finally, we show that many environments and parameter configurations reflect well-known, open problems in RL research, allowing researchers to continue exploring these fundamental problems in a surgical context. We aim to provide a challenging, standard environment suite for further development of RL for RALS, ultimately helping to realize the full potential of cognitive surgical robotics. LapGym is publicly accessible through GitHub (https://github.com/ScheiklP/lap_gym).

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arXiv2022

Biomedical image analysis competitions: The state of current participation practice

The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.

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arXiv2022

LapSeg3D: Weakly Supervised Semantic Segmentation of Point Clouds Representing Laparoscopic Scenes

The semantic segmentation of surgical scenes is a prerequisite for task automation in robot assisted interventions. We propose LapSeg3D, a novel DNN-based approach for the voxel-wise annotation of point clouds representing surgical scenes. As the manual annotation of training data is highly time consuming, we introduce a semi-autonomous clustering-based pipeline for the annotation of the gallbladder, which is used to generate segmented labels for the DNN. When evaluated against manually annotated data, LapSeg3D achieves an F1 score of 0.94 for gallbladder segmentation on various datasets of ex-vivo porcine livers. We show LapSeg3D to generalize accurately across different gallbladders and datasets recorded with different RGB-D camera systems.

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arXiv2021

Robust deep learning-based semantic organ segmentation in hyperspectral images

Semantic image segmentation is an important prerequisite for context-awareness and autonomous robotics in surgery. The state of the art has focused on conventional RGB video data acquired during minimally invasive surgery, but full-scene semantic segmentation based on spectral imaging data and obtained during open surgery has received almost no attention to date. To address this gap in the literature, we are investigating the following research questions based on hyperspectral imaging (HSI) data of pigs acquired in an open surgery setting: (1) What is an adequate representation of HSI data for neural network-based fully automated organ segmentation, especially with respect to the spatial granularity of the data (pixels vs. superpixels vs. patches vs. full images)? (2) Is there a benefit of using HSI data compared to other modalities, namely RGB data and processed HSI data (e.g. tissue parameters like oxygenation), when performing semantic organ segmentation? According to a comprehensive validation study based on 506 HSI images from 20 pigs, annotated with a total of 19 classes, deep learning-based segmentation performance increases, consistently across modalities, with the spatial context of the input data. Unprocessed HSI data offers an advantage over RGB data or processed data from the camera provider, with the advantage increasing with decreasing size of the input to the neural network. Maximum performance (HSI applied to whole images) yielded a mean DSC of 0.90 ((standard deviation (SD)) 0.04), which is in the range of the inter-rater variability (DSC of 0.89 ((standard deviation (SD)) 0.07)). We conclude that HSI could become a powerful image modality for fully-automatic surgical scene understanding with many advantages over traditional imaging, including the ability to recover additional functional tissue information. Code and pre-trained models: https://github.com/IMSY-DKFZ/htc.

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arXiv2021

Cooperative Assistance in Robotic Surgery through Multi-Agent Reinforcement Learning

Cognitive cooperative assistance in robot-assisted surgery holds the potential to increase quality of care in minimally invasive interventions. Automation of surgical tasks promises to reduce the mental exertion and fatigue of surgeons. In this work, multi-agent reinforcement learning is demonstrated to be robust to the distribution shift introduced by pairing a learned policy with a human team member. Multi-agent policies are trained directly from images in simulation to control multiple instruments in a sub task of the minimally invasive removal of the gallbladder. These agents are evaluated individually and in cooperation with humans to demonstrate their suitability as autonomous assistants. Compared to human teams, the hybrid teams with artificial agents perform better considering completion time (44.4% to 71.2% shorter) as well as number of collisions (44.7% to 98.0% fewer). Path lengths, however, increase under control of an artificial agent (11.4% to 33.5% longer). A multi-agent formulation of the learning problem was favored over a single-agent formulation on this surgical sub task, due to the sequential learning of the two instruments. This approach may be extended to other tasks that are difficult to formulate within the standard reinforcement learning framework. Multi-agent reinforcement learning may shift the paradigm of cognitive robotic surgery towards seamless cooperation between surgeons and assistive technologies.

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arXiv2021

Comparative Validation of Machine Learning Algorithms for Surgical Workflow and Skill Analysis with the HeiChole Benchmark

PURPOSE: Surgical workflow and skill analysis are key technologies for the next generation of cognitive surgical assistance systems. These systems could increase the safety of the operation through context-sensitive warnings and semi-autonomous robotic assistance or improve training of surgeons via data-driven feedback. In surgical workflow analysis up to 91% average precision has been reported for phase recognition on an open data single-center dataset. In this work we investigated the generalizability of phase recognition algorithms in a multi-center setting including more difficult recognition tasks such as surgical action and surgical skill. METHODS: To achieve this goal, a dataset with 33 laparoscopic cholecystectomy videos from three surgical centers with a total operation time of 22 hours was created. Labels included annotation of seven surgical phases with 250 phase transitions, 5514 occurences of four surgical actions, 6980 occurences of 21 surgical instruments from seven instrument categories and 495 skill classifications in five skill dimensions. The dataset was used in the 2019 Endoscopic Vision challenge, sub-challenge for surgical workflow and skill analysis. Here, 12 teams submitted their machine learning algorithms for recognition of phase, action, instrument and/or skill assessment. RESULTS: F1-scores were achieved for phase recognition between 23.9% and 67.7% (n=9 teams), for instrument presence detection between 38.5% and 63.8% (n=8 teams), but for action recognition only between 21.8% and 23.3% (n=5 teams). The average absolute error for skill assessment was 0.78 (n=1 team). CONCLUSION: Surgical workflow and skill analysis are promising technologies to support the surgical team, but are not solved yet, as shown by our comparison of algorithms. This novel benchmark can be used for comparable evaluation and validation of future work.

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