Deep learning approaches to surgical video segmentation and object detection: A Scoping Review

Introduction: Computer vision (CV) has had a transformative impact in biomedical fields such as radiology, dermatology, and pathology. Its real-world adoption in surgical applications, however, remains limited. We review the current state-of-the-art performance of deep learning (DL)-based CV models for segmentation and object detection of anatomical structures in videos obtained during surgical procedures. Methods: We conducted a scoping review of studies on semantic segmentation and object detection of anatomical structures published between 2014 and 2024 from 3 major databases - PubMed, Embase, and IEEE Xplore. The primary objective was to evaluate the state-of-the-art performance of semantic segmentation in surgical videos. Secondary objectives included examining DL models, progress toward clinical applications, and the specific challenges with segmentation of organs/tissues in surgical videos. Results: We identified 58 relevant published studies. These focused predominantly on procedures from general surgery [20(34.4%)], colorectal surgery [9(15.5%)], and neurosurgery [8(13.8%)]. Cholecystectomy [14(24.1%)] and low anterior rectal resection [5(8.6%)] were the most common procedures addressed. Semantic segmentation [47(81%)] was the primary CV task. U-Net [14(24.1%)] and DeepLab [13(22.4%)] were the most widely used models. Larger organs such as the liver (Dice score: 0.88) had higher accuracy compared to smaller structures such as nerves (Dice score: 0.49). Models demonstrated real-time inference potential ranging from 5-298 frames-per-second (fps). Conclusion: This review highlights the significant progress made in DL-based semantic segmentation for surgical videos with real-time applicability, particularly for larger organs. Addressing challenges with smaller structures, data availability, and generalizability remains crucial for future advancements.

Devanish N. Kamtam, Joseph B. Shrager, Satya Deepya Malla, Nicole Lin, Juan J. Cardona, Jake J. Kim, Clarence Hu · 2025