PinPoint: Monocular Needle Pose Estimation for Robotic Suturing via Stein Variational Newton and Geometric Residuals

Purpose: Accurate 6 DoF pose estimation of surgical tools is critical for automa- tion, robotic proprioception, and safe interaction with the tissue operated on. Kinematics-based approaches suffer from accumulated errors due to the cable- driven nature of robotic arms, while vision-based methods often rely on external markers or trackers. Although more recent vision-based advances have been pro- posed, these two-stage pose estimation methods often lack real-time robustness due to accumulated errors and computational overhead. Methods: We propose a novel end-to-end trainable model, PICO. Our model employs a multi-task learning architecture to predict segmentation and depth maps, alongside regression of translation and rotation parameters. We define two proxy tasks that enforce geometric consistency in both 2D and 3D spaces, improving accuracy and robustness. For this, we propose a projection loss, and a point-to-point loss. Results: We evaluate our method on the SurgRIPE dataset, benchmarking its performance against state-of-the-art approaches using standard 6DoF pose esti- mation metrics. Our results demonstrate consistently strong performance across all four subsets, specifically in rotation, ranking second even under occlusion. It also demonstrates comparable translational performance, remaining competitive, especially in occluded cases. Conclusion: PICO demonstrates the effectiveness of multi-task learning and geometry-aware proxy tasks for robust and reliable surgical tool pose estimation, especially in occluded scenarios, highlighting potential for future applications.

Predicting surgical needle trajectories from endoscopic video is critical for robot-assisted suturing, enabling anticipatory planning, real-time guidance, and safer motion execution. Existing methods that directly learn motion distributions from visual observations tend to overlook the sequential dependency among adjacent motion steps. Moreover, sparse waypoint annotations often fail to provide sufficient supervision, further increasing the difficulty of supervised or imitation learning methods. To address these challenges, we formulate image-based needle trajectory prediction as a sequential decision-making problem, in which the needle tip is treated as an agent that moves step by step in pixel space. This formulation naturally captures the continuity of needle motion and enables the explicit modeling of physically plausible pixel-wise state transitions over time. From this perspective, we propose SutureFormer, a goal-conditioned offline reinforcement learning framework that leverages sparse annotations to dense reward signals via cubic spline interpolation, encouraging the policy to exploit limited expert guidance while exploring plausible future motion paths. SutureFormer encodes variable-length clips using an observation encoder to capture both local spatial cues and long-range temporal dynamics, and autoregressively predicts future waypoints through actions composed of discrete directions and continuous magnitudes. To enable stable offline policy optimization from expert demonstrations, we adopt Conservative Q-Learning with Behavioral Cloning regularization. Experiments on a new kidney wound suturing dataset containing 1,158 trajectories from 50 patients show that SutureFormer reduces Average Displacement Error by 58.6% compared with the strongest baseline, demonstrating the effectiveness of modeling needle trajectory prediction as pixel-level sequential action learning.

Suture-needle pickup is necessary for autonomous suturing, as a needle can be unexpectedly dropped or strategically released to adjust the grasping configuration. Current methods for autonomous needle pickup typically guide a robot to move straight toward the needle and grasp it, limited to conditions where the needle is observable and directly approachable. In addition, grasping the needle lying on tissue can lead to the robot pinching nearby tissue or the needle jumping around due to its slippery surface, posing potential safety issues. This work proposes an autonomous framework that uses a suture thread as an assistive tool for indirect needle pickup, avoiding unnecessary tool-tissue contact and enabling pickup even when the needle is occluded or inaccessible. The framework spans the entire workflow, including thread and tissue reconstruction, safe grasp-point selection, stable thread lifting, and bimanual thread-following until securing needle grasping. The robot policies account for visual uncertainty to maximize robustness in real-world environments. We evaluate the proposed framework on a da Vinci Research Kit under various real-world conditions. The results demonstrate robust performance even with a challenging thread configuration or a non-approachable needle, closing the gap in applying autonomous robot policies to unstructured suturing environments.