Procedure Recognition by Knowledge-Driven Segmentation in Robotic-Assisted Vitreoretinal Surgery

Internal limiting membrane (ILM) peeling is a vital vitreoretinal surgery procedure. However, due to the thickness of just 1-2 micrometers and the intricacies associated with its varying density and adhesion, the difficulty of manipulation exceeds the physiological limits of human perception and operation. Surgical robot is characterized by high precision and stability. However, navigating intricate intraocular environments and handling minuscule high-precision areas remain enormous challenges. These include issues of uneven lighting, field-of-view loss, and motion blur. This paper proposed a perception method named ‘Multimodal Surgical Process Recognition based on Domain Knowledge and Segmentation (MSPR-DKS),’ designed to address these challenges and provide input for the precise control of robots. Moreover, a comprehensive dataset focused on ILM peeling during macular hole surgeries was established. Experimental results underscore the efficacy of this approach, with segmentation accuracies exceeding 99.27% for instruments and macular holes and an average accuracy of 98.97% in recognizing surgical processes. This study paves the way for leveraging domain knowledge and image segmentation to improve robot-assisted manipulation of soft tissues in ophthalmology.