SurgiATM: A Physics-Guided Plug-and-Play Model for Deep Learning-Based Smoke Removal in Laparoscopic Surgery
Authors: Mingyu Sheng, Jianan Fan, Dongnan Liu, Guoyan Zheng, Ron Kikinis, Weidong Cai
Organizations: School of Computer Science, The University of Sydney, Sydney, NSW, Australia · Institute of Medical Robotics, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China · Department of Radiology, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA, United States
Abstract
During laparoscopic surgery, smoke generated by tissue cauterization can significantly degrade the visual quality of endoscopic frames, increasing the risk of surgical errors and hindering both clinical decision-making and computer-assisted visual analysis. Consequently, removing surgical smoke is critical to ensuring patient safety and maintaining operative efficiency. In this study, we propose the Surgical Atmospheric Model (SurgiATM) for surgical smoke removal. SurgiATM statistically bridges a physics-based atmospheric model and data-driven deep learning models, combining the superior generalizability of the former with the high accuracy of the latter. Furthermore, SurgiATM is designed as a lightweight module that can be easily integrated into existing surgical desmoking architectures with minimal modification, aiming to enhance their accuracy and stability. The proposed method is derived via statistically optimizing a Mixture-of-Experts (MoE) model at the output end of arbitrary deep learning methods, with a Laplacian-like error distribution specifically leveraged to model surgical smoke. The output-stage MoE ensures minimal modification to the architecture of the original methods, while the Laplacian-like distribution characteristic of surgical smoke enables a lightweight reconstruction formulation with minimal parameters. Therefore, SurgiATM introduces only two hyperparameters and no additional trainable weights, preserving the original network architecture with minimal computational and modification overhead. We conduct extensive experiments on three public surgical datasets with ten desmoking methods, involving multiple network architectures and covering diverse procedures, including cholecystectomy, partial nephrectomy, and diaphragm dissection.
Wildfires are a major producer of fine particulate matter, impacting human health and the electrical grid. Accurately forecasting smoke impacts over long time scales incorporates fuel treatment strategies, natural fuel succession, and stochastic events like lightning strikes. However, predicting smoke for each fuel distribution with a forward simulation of a coupled fire-atmosphere model is computationally infeasible. Moreover, relatively simple fire models are tractable to run in many long-time scenarios but do not capture smoke transport. We use data-driven multilinear operators to predict a smoke concentration field from knowledge of the time since ignition for two quantities of interest: aerosol optical depth and smoke detection. Our method first computes the principal components of time-since-ignition and smoke concentration fields and then learns a map from powers of the input coefficients to the output coefficients. We apply our learned operator to smoke prediction in the Upper Rio Grande Watershed. After collecting training data, learning the approximation weights on a CPU takes less than 30 seconds, and each forward call takes less than 1 ms. On a proxy for aerosol optical depth, we obtain equal accuracy to Monte Carlo sampling with fewer than half as many coupled model calls. For smoke detection, we obtain an intersection-over-union (IoU) of 0.64 and an area under the receiver operating characteristic curve (AUC) of 0.95 on holdout data. Our method is significantly more accurate than the most similar published smoke classifier, which obtains an IoU and AUC of 0.15 and 0.61, respectively, on a 2015 bushfire in Australia.
Zachary Morrow, Joseph Crockett, John D. Jakeman +1
Rapid and accurate wildfire smoke severity assessment from satellite images is essential for emergency response, air quality modeling, and human health risk management. Existing deep learning approaches treat smoke detection as a binary task, producing point estimates without any measure of prediction confidence. We propose a probabilistic framework to categorize a satellite patch into Light, Moderate, and Heavy severity classes and to provide decomposed epistemic and aleatoric uncertainty in a single forward pass. Our architecture uses the backbone of a pre-trained EfficientNet-B3 and a CBAM module with an evidential deep learning head that predicts Dirichlet concentration parameters, directly estimating vacuity (epistemic) and dissonance (aleatoric) without Monte Carlo sampling. Evaluated on 16,298 real satellite patches derived from the Wildfire Detection dataset, our model achieves 93.8% weighted test accuracy (91.1% unweighted) with ECE=0.0274. Selective prediction retaining the most certain 50% of patches achieves 96.7% accuracy. As image quality degrades, uncertainty increases monotonically, and vacuity is a practical scan quality measure. The Moderate class represents transitional smoke conditions that exhibit the highest epistemic uncertainty (mean vacuity = 0.187), confirming the model correctly identifies ambiguous smoke boundary regions. CBAM spatial attention maps localize to structurally distinctive scene regions, and t-SNE demonstrates the clear cluster separation of Light and Heavy smoke.
Vision-Language-Action (VLA) models represent a promising direction for embodied intelligence in surgical robotics. Despite the prevalence of VLA benchmarks for general robotics, standardized evaluation platforms specifically designed for surgical contexts remain absent. To address this limitation, we present SurgVLA-Bench, the first comprehensive benchmark for evaluating VLA models in laparoscopic surgical robotics. Leveraging the SurRoL simulation platform, we construct a hierarchical task taxonomy ranging from atomic actions to complete surgical procedures, complemented by a multi-dimensional evaluation framework assessing action accuracy and semantic consistency. We then systematically evaluate two representative paradigms, including autoregressive models such as OpenVLA, and flow matching models such as π0, π0.5, and SmolVLA. Our experiments show that autoregressive models tend to excel in semantic understanding, while flow matching models often achieve higher task precision but may face generalization trade-offs. However, even the best-performing models remain far from satisfactory, as the constrained endoscopic field of view, restricted viewing angles, and frequent occlusions persist as fundamental physical bottlenecks. The code and data are available at https://github.com/VCL-HNU/SurgVLA