Computer Vision News - November 2021

69 Pietro Mascagni at Camma Lab “Modern surgery has become a complex socio-technical process, with multiple highly specialized professionals coordinating and taking decisions in seconds, interpreting signals from highly technological devices,” Pietro explains . “The process of surgical care, when it goes smoothly, is highly effective, but it’s also highly error prone, and the complexity can be described as a problem of information flow. We have analytics that are great at modeling this kind of unstructured information and could be used to deliver the right information to the right person at the right time.” This is the vision that motivated computer scientists and surgeons to team up in recent years to establish the field of surgical data science, which has huge potential for improving preoperative, intraoperative, and postoperative care . Pietro is focusedon translating that vision into something concrete by developing software that supports surgeons intraoperatively in operating rooms. 65% of medical error happens there, and an estimated 50% of complications are preventable. “The fact is we know very little about what happens in the operating room because it is kind of a black box,” he points out. “The only direct information on operating room activity is operator- written reports, so I’m using videos to shine a light on what happens.” The practical test case for this is cholecystectomy - the surgical removal of the gallbladder. It is a very common abdominal surgical procedure performed with a minimally invasive laparoscopic approach in 98% of cases. An endoscopic camera is inserted into the abdomen and a video guides the surgeon’s movement, which is digital information that could be analyzed by deep learning and computer vision methods. “We want to improve safety in cholecystectomy, in particular the risk of bile duct injury,” Pietro tells us. “The gallbladder sits underneath the liver, connected by the biliary tree to the gut. You need to detach the gallbladderfrom the biliary tree to remove it. Every clinical outcome improved with the introduction of the minimally invasive technique, except the rate of bile duct injury. When there is a bile duct injury it’s not usually a technical mistake.