Cholec80-port: A Geometrically Consistent Trocar Port Segmentation Dataset for Robust Surgical Scene Understanding

Improving the reliability and completeness of colonoscopic inspection is critical for reducing missed lesions and improving colorectal cancer prevention. Reliable scene understanding is essential for navigation, reconstruction, and assessment of inspection completeness. Anatomical structures such as mucosal folds provide stable geometric cues for endoscope localization, while surgical instruments introduce dynamic occlusions that complicate visual interpretation. However, existing gastrointestinal endoscopy datasets largely focus on disease detection or artifact segmentation, leaving a gap in precise annotations of structural landmarks and instruments. We introduce SegCol, a dataset and benchmark for semantic segmentation of colon fold edges and surgical instruments derived from the EndoMapper dataset. SegCol provides manually annotated pixel-level masks for three instrument classes and thin fold-edge structures across temporally consistent image sequences. It forms the basis of the SegCol Challenge, organized as part of the EndoVis Challenge at MICCAI 2024, evaluating both supervised segmentation and annotation-efficient active learning. We further study segmentation metrics, including Dice, ODS/OIS, AP, and CLDice, under structural perturbations and different object geometries, and analyze participating methods, architectural choices, and active learning strategies. Our findings show that metric behavior strongly depends on target structure, highlighting the need for carefully selected evaluation protocols in endoscopic segmentation. Details are available at https://www.synapse.org/Synapse:syn54124209/wiki/626563, and code at https://github.com/surgical-vision/segcol_challenge.

Accurate recognition of anatomical structures is essential for safe and effective minimally invasive surgery (MIS), yet it remains underexplored in surgical computer vision due to limited annotated data and methods tailored primarily to natural scenes. In this work, we present a combined dataset and model framework to advance anatomy-aware perception in MIS. First, we introduce ATLAS-120k, a large-scale clip-level semantic segmentation dataset comprising over 120,000 annotated frames from 100 surgical videos spanning 14 procedures and multiple modalities, including laparoscopic and robot-assisted surgery. The dataset captures substantial procedural variability and was created using a scalable annotation pipeline that integrates expert manual labeling, automated propagation, iterative refinement, and surgeon verification to ensure high-quality annotations. Second, we propose ATLAS (Anatomy Recognition with Context Learning using Foundation Representations), a video semantic segmentation model specifically designed for surgical anatomy recognition. Unlike conventional approaches that emphasize object tracking, ATLAS leverages foundation-model embeddings together with lightweight temporal reasoning to incorporate contextual cues such as procedure type, surgical phase, and short-term visual memory. This design enables temporally consistent and accurate predictions while maintaining real-time feasibility. Together, the dataset and model establish a practical foundation for robust surgical scene understanding and support the development of clinically applicable guidance systems for minimally invasive surgery. The models, dataset annotations and annotation platform are publicly available at: https://github.com/TimJaspers0801/ATLAS.

Automated assessment of the Critical View of Safety (CVS) in laparoscopic cholecystectomy requires both recognition of the three CVS criteria and anatomical grounding in small, rare, and often occluded hepatocystic structures. Learning-based methods differ in the anatomical information they use, from image-level classification to detection, segmentation, or graph-based reasoning, yet grounding the safety-critical anatomy remains the main bottleneck. We propose CasCVS-Net, a staged multi-task cascade that jointly performs object detection, semantic segmentation, and CVS assessment, trained on the Endoscapes dataset. The model couples the tasks through predicted anatomy: predicted boxes guide segmentation, and predicted masks provide region-level features for CVS classification, so CVS assessment at inference uses only model predictions rather than ground-truth annotations. To reduce optimisation instability in this coupled setting, training progresses from detection to detection-segmentation and then to the full three-task cascade, followed by task-wise fine-tuning. Evaluation on the public unseen test set shows that CasCVS-Net improves over matched single-task baselines on all three tasks, achieving 32.0 detection mAP, 46.8 semantic mIoU, 15.3 rare-anatomy mIoU, and 67.2 CVS mAP. It outperforms the state-of-the-art LG-CVS and SV2LSTG by 6.3% and 4.5% relative CVS mAP, respectively, corresponding to 4.0 and 2.9 mAP points. These results show that staged task coupling through predicted boxes and masks improves anatomical grounding for CVS assessment, particularly for rare hepatocystic structures.