SurgPhase: Time efficient pituitary tumor surgery phase recognition via an interactive web platform
Organizations: Children’s National Hospital, 111 Michigan Ave NW, Washington, 20010, DC, USA · Surgical Data Science Collective, 2000 Pennsylvania Ave. NW, Suite 7000, Washington, 20006, DC, USA · Booth School of Business, University of Chicago, 5807 S Woodlawn Ave, Chicago, 60637, IL, USA · Stanford University School of Medicine, 300 Pasteur Drive, Stanford, 94305, CA, USA ·
Abstract
Accurate surgical phase recognition is essential for analyzing procedural workflows, supporting intraoperative decision-making, and enabling data-driven improvements in surgical education and performance evaluation. In this work, we present a comprehensive framework for phase recognition in pituitary tumor surgery (PTS) videos, combining self-supervised representation learning, robust temporal modeling, and scalable data annotation strategies. Our method achieves 90% accuracy on a held-out test set, outperforming current state-of-the-art approaches and demonstrating strong generalization across variable surgical cases. A central contribution of this work is the integration of a collaborative online platform designed for surgeons to upload surgical videos, receive automated phase analysis, and contribute to a growing dataset. This platform not only facilitates large-scale data collection but also fosters knowledge sharing and continuous model improvement. To address the challenge of limited labeled data, we pretrain a ResNet-50 model using the self-supervised framework on 251 unlabeled PTS videos, enabling the extraction of high-quality feature representations. Fine-tuning is performed on a labeled dataset of 81 procedures using a modified training regime that incorporates focal loss, gradual layer unfreezing, and dynamic sampling to address class imbalance and procedural variability.
Figures & tables
| Method | Phase | Pre | Rec | F1 | Acc |
| SurgPhase (Our method) | Nasal | 94.22 | 88.75 | 91.40 | 90.00 |
| Sphenoid | 81.97 | 78.27 | 80.08 | ||
| Sellar | 89.99 | 95.24 | 92.54 | ||
| Closure | 95.83 | 80.81 | 87.68 | ||
| CITI | All phases | - | - | 61.10 | - |
| UNI-ANDES | - | - | 51.00 | - |
| Method | Phase | Pre | Rec | F1 | Acc | Pre | Rec | F1 |
| SurgPhase w/ BCE w/o SSL | Nasal | 81.73 | 70.83 | 75.89 | 78.12 | 76.05 | 80.10 | 77.34 |
| Sphenoid | 73.13 | 94.78 | 82.56 | |||||
| Sellar | 91.65 | 76.25 | 83.25 | |||||
| Closure | 55.65 | 77.89 | 64.92 | |||||
| SurgPhase w/ focal loss w/o SSL | Nasal | 92.88 | 42.62 | 58.43 | 81.22 | 83.37 | 74.84 | 76.01 |
| Sphenoid | 90.34 | 90.30 | 90.32 |
Surgical Video Understanding
Surgical video understanding uses computer vision and multimodal AI to interpret procedures, instruments, actions, and events over time.
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