Surgical Instrument Tracking

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16 papers7 papers in the last four weeks, against 1 the four weeks before. 0.0% of all new papers.

Oct 13, 2026

Augmenting Real-time Visualization in Minimally Invasive Surgery with Particle Filtering and Depth-Aware Occlusion Handling

We present a real-time, hybrid framework for occlusion handling and depth-aware tracking in minimally invasive surgeries (MIS). Occlusions caused by surgical instruments often obscure the region of interest (ROI), affecting surgical precision. To address this, our approach integrates enhanced You Only Look Once (YOLO) based detection, Particle Filtering (PF), and monocular depth estimation using Multiple Depth Estimation Accuracy with Single Network (MiDaS). Occlusion is detected using a distance-based threshold between instruments and ROI. Experimental results demonstrate robust instrument detection with a confidence score of 0.85, effective occlusion event handling, and accurate depth prediction with an MAE of 0.34 cm and RMSE of 0.53 cm. Independent phantom-based validation against stereo depth measurements yielded an MAE of 0.65 cm and RMSE of 0.66 cm. The framework further achieved an occlusion detection accuracy of 81.95% while maintaining real-time performance at 38.7 FPS. Preliminary surgeon feedback indicates that the proposed visualization framework is clinically relevant and holds promise for future intraoperative image-guided navigation and decision support in MIS.

Anuska Sarkar, Partha Acharya, Vishnu Nandury +2

School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302 India · Computer Science Department, Arizona State University, Tempe, Arizona 85287 USA · Narayana Hospital, Kolkata 700107 India

Surgical Instrument Tracking Occlusion Reasoning Surgical Video Understanding

Oct 6, 2026

LARK: A Low-Cost, Accurate, Occlusion-Resilient, Kalman Filter-Assisted Tracking System for Image-Guided Surgery

Image-guided surgery (IGS) depends on accurate tracking of surgical instruments to provide real-time navigation relative to anatomical structures. Commercial stereo infrared trackers are accurate but prone to occlusion and cost-prohibitive for many settings. This work presents LARK, a multi-camera optical tracking system using commodity RGB hardware and multi-view redundancy and fusion. We develop and evaluate two complete tracking methods: multi-view monocular pose fusion and multi-view triangulation. Both methods are assessed under varying occlusion levels using a precision-machined grid and an anatomical head phantom, and compared against a gold-standard stereo infrared system. With five cameras and adaptive Kalman filtering, LARK achieves median target registration errors of 0.64 mm for point localization with triangulation and 0.73 mm for trajectory tracking with pose fusion on the machined grid. Camera-subset experiments show graceful degradation in adaptive pose-fusion accuracy as fewer views remain available. With tracking hardware costing under $1,000 USD, LARK provides a low-cost platform for image-guided surgery research. Hardware designs and software are publicly available at https://nist.mni.mcgill.ca/software/ , and datasets at https://nist.mni.mcgill.ca/data/ .

George Sideris, Justin Cree, Andrew Stirling +3

Department of Mechanical Engineering, McGill University, Montreal, Canada · Montreal Neurological Institute, McGill University, Montreal, Canada

Visual Object Tracking Surgical Instrument Tracking

Oct 4, 2026

Robust Surgical Robotic Instrument Tracking via Sequential Multi-Cue Fusion and Sim-to-Real Self-Training

Efficient and robust tracking of surgical robotic instruments is important for robot-assisted minimally invasive surgery, yet remains challenging due to the complexity of surgical scenes and the unconventional geometry of surgical instruments. Keypoint-based approaches are efficient, but their performance depends on reliable feature detection. Improving these detectors with real-world supervision is difficult because accurate real-world annotations are costly to obtain at scale. To address this limitation, we introduce a tracker-guided self-training framework that adapts a model pretrained on synthetic images to unlabeled real-world videos. Given measured robot joint states, an uncertainty-aware EKF recursively corrects the instrument pose and the observable joint angles by comparing projected model features with detected keypoints, shaft boundaries, and mask-derived cues. An RTS smoother subsequently refines the resulting trajectory, which is projected into pseudo-labels for fine-tuning the feature detector without laborious pose annotations. Experiments on real-world videos demonstrate consistent improvements from self-training across all evaluated keypoint metrics, and the resulting model outperforms prior approaches in both accuracy and runtime. The code and data will be released upon publication.

Hanyang Hu, Zekai Liang, Florian Richter +1

Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093 USA.

Self-Training Sim-to-Real Transfer Surgical Instrument Tracking Surgical Video Understanding Surgical Robotics

Sep 30, 2026

Drape-Compatible Tool-Tip Localization for Hand-Held Laparoscopic Instruments via UWB Carrier-Phase Ranging and Trocar-Constrained Geometry

A surgical robot policy needs to know where each instrument's working end sits relative to the camera and to the other instrument, yet a laparoscopic operation leaves only the endoscope video, and a draped instrument hides every optical path on itself. We estimate the tool tips from distances and an IMU alone. The distances are measured by ultra-wideband carrier phase between antenna nodes on the handle side of the instruments: one per hand-held instrument, one on the endoscope, all outside the sterile barrier. Take the endoscope antenna as the reference. The two instrument antennas carry six coordinates while the three pairs give three distances, so the problem is short by three, and averaging cannot close that gap because what is missing is information, not precision. Carrier phase adds one more unknown per pair, an integer that leaves distance fixed only modulo lambda/2 = 23.1 mm. The trocar settles both difficulties: each shaft passes through a port whose position is known and whose direction the on-board IMU measures, so its antenna keeps a single degree of freedom, the insertion depth. Two unknowns now face three distances -- two fix the depths and the third is left over, and that spare equation exposes a wrong integer or a wrong mounting offset instead of absorbing it. The same solve returns both tool tips in the endoscope frame, without the second carrier frequency that integer resolution usually needs, so the link never leaves a single PLL lock. In an 11-hole phantom among metal instruments the three distances hold sigma = 0.10-0.33 mm at 35-46 Hz, a sterile drape pressed onto the antennas leaves the link unchanged where an optical path would be blocked, and the logger was carried into a live rabbit appendectomy.

Jinseok Lee, Dongho Yee, Minsung Kim +8

Department of Transdisciplinary Medicine, Seoul National University Hospital. · Rosota Inc., Seoul, Republic of Korea. · Department of Mechanical Engineering, Seoul National University. +5

Relative Pose Estimation Surgical Robotics Surgical Instrument Tracking

Sep 23, 2026

Surgical Kinematics from Monocular Video with Learned Articulated Motion Constraints

Objective assessment of robotic surgery uses instrument kinematics, which must be reconstructed when only video is available. We introduce a kinematic reconstruction network for estimating instrument position, orientation and jaw angle from monocular video. Our visual representation combines global attention pooling of frozen DINOv3 features with local pooling at instrument landmarks from fine-tuned SAM 3.1 masks. Our shared Transformer encoder and temporal convolutional heads integrate this representation with mask geometry, monocular depth and visual state estimates from arm-specific multilayer regression networks. Our position branch predicts displacement magnitude and direction separately to preserve traveled distance. We fit trajectories to predicted state observations and motion increments by differentiable weighted least squares, expressing quaternion observations relative to cumulative predicted rotations to obtain a quadratic orientation objective. We evaluate reconstruction across 2,802 Open-H episodes. Compared with LiveMAE on the main Open-H benchmark, our method reduces path-length mean absolute error from 0.45 to 0.34,cm and increases temporal mean average precision for motion segmentation from 44.54% to 54.44%.

Mehmet Kerem Turkcan, Soham Samal, Zoran Kostic

Columbia University, New York, NY, USA

Surgical Robotics Robot Kinematics Object Pose Estimation Articulated Object Reconstruction Motion Segmentation Robot State Estimation+1

Sep 22, 2026

From Instrument-Mounted Demonstrations to In-Vivo Execution: Learning Bimanual Laparoscopic Appendectomy Without Robot-Collected Demonstrations

Most minimally invasive surgery is still performed with hand-held laparoscopic instruments, and the surgeon's instrument kinematics are lost when the operation ends; only the endoscope video is kept. This paper presents an end-to-end pipeline that captures this motion in the operating room and uses it to train a surgical robot policy, validated on live animals. We introduce a surgical instrument-state logger that mounts on the shaft of a standard laparoscopic instrument and recovers its pose and jaw state from an inertial sensor, a time-of-flight sensor and a Hall sensor, with no external camera or tracker. A data pipeline measures the latency of every sensor channel against a robot ground truth and aligns the channels before forming observation-action pairs. On these demonstrations we train a diffusion policy with a fine-tuned DINOv3 backbone, selecting its design by closed-loop rollouts in a physics simulator reconstructed from depth maps of an ex-vivo rabbit appendix. The policy is then retrained on 849 in-vivo demonstrations from four live rabbits and deployed on four additional live rabbits with electrosurgery armed. With the surgeon selecting the surgical phase, the policy completed the appendectomy in three of the four animals. The results show that demonstrations recorded from a surgeon's own instruments are sufficient to train, select and deploy a bimanual surgical policy in vivo. The robot serves only as the timing reference for sensor calibration and as the executor, and collects no demonstrations. Both demonstration corpora are released to support future surgical robot learning research.

Dongho Yee, Juahn Oh, Jinseok Lee +10

Department of Transdisciplinary Medicine, Seoul National University Hospital · Rosota Inc., Seoul, Republic of Korea · Department of Mechanical Engineering, Seoul National University +8

Bimanual Robotic Manipulation Learning from Demonstration Robot Imitation Learning Surgical Robotics Surgical Instrument Tracking

Sep 22, 2026

Recording Hand-Held Laparoscopic Instrument Motion in the Operating Room: Magnetometer-Free Fusion of Inertial, Range and Visual Sensing

Most minimally invasive procedures are still performed with hand-held laparoscopic instruments, yet only the endoscopic video is retained; the instrument motion that expresses surgical skill, and that could support skill assessment and robot learning, is lost. Pose from video alone remains millimeters to centimeters off, and an instrument-mounted inertial measurement unit (IMU) cannot rely on its magnetometer, whose field changed with tool pose and between sessions in our measurements. We present a surgical instrument-state logger that clips onto a conventional instrument without modifying the part that enters the patient and fuses a six-axis IMU and a time-of-flight (ToF) rangefinder with a markerless camera in an error-state Kalman filter under the remote center of motion (RCM) of the trocar. Heading comes from the shaft silhouette, segmented by a U-Net, in place of the magnetometer: the rotation-angle error is 0.200°, against 3.58° from the accelerometer and magnetometer alone. Against a Franka Research 3 manipulator, and without alignment to it, the displacement error over 300 translation trials was 1.21mm RMS and the relative-rotation error over 180 rotation trials 0.34° RMS. On continuous trajectories, tracked and displayed in real time, the absolute tip error was 1.22mm (programmed) and 3.04mm (teleoperated) after post-hoc tuning of three filter parameters, and the full fusion beat every sensor subset. Because the estimator uses no magnetic measurement, its accuracy does not rely on an undisturbed field. The same clip-on device could thus record metric tip trajectories during routine hand-held laparoscopy, while displaying the insertion depth and attitude that are hidden once the instrument is inside the patient.

Jiyul Lee, Dongho Yee, Juahn Oh +9

Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, Republic of Korea. · Rosota Inc., Seoul, Republic of Korea. · Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. +6

Object Pose Estimation Error-State Kalman Filtering Surgical Robotics Multimodal Sensor Fusion Surgical Instrument Tracking

Sep 16, 2026

RAUL: Reference-Assisted Ureteroscopy Localization for Skill Assessment

Objective: Incomplete navigation of anatomy during ureteroscopic kidney stone surgeries can contribute to repeat interventions. While skilled surgeons have lower reintervention rates, there are no objective metrics to quantify scope-navigation performance to evaluate when a trainee becomes skilled. This work aims to recover ureteroscope trajectories from endoscopic video and derive navigation metrics to quantify differences in skill. Methods: We propose RAUL, a reference-assisted reconstruction framework for recovering ureteroscope trajectories from ureteroscope videos only in phantoms. For each phantom, we use a slow, high-quality reference exploration video to generate a reference reconstruction. We localize subsequent exploration videos against this reference. We evaluate localization accuracy against electromagnetically tracked scope pose. We compute navigation metrics from phantom exploration trajectories to compare surgical residents across experience levels. Results: The proposed reference-assisted framework achieves a mean translation root mean square error of

0.5 \pm 0.1

mm across 9 phantoms. Compared to standard Structure-from-Motion (SfM), the proposed pipeline increases frame-wise localization coverage from

50.5 \pm 14.9\%

to

86.1 \pm 7.2\%

of all video frames. The reconstructed trajectories revealed significant differences between high- and low-experience trainees in established navigation metrics. Conclusion: RAUL enables substantially more complete recovery of ureteroscope trajectories from videos compared to standard SfM pipelines, enabling trajectory-based skill assessment without additional tracking equipment. Significance: To the best of our knowledge, this is the first use of video-only recovery of ureteroscope trajectories without external tracking sensors for skill assessment, supporting scalable automated assessment of ureteroscopy navigation skill.

Fangjie Li, Mai Bui, Charan Mohan +4

Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37240 USA · Department of Computer Science, Vanderbilt University, Nashville, TN 37240 USA · Department of Urology, Vanderbilt University Medical Center, Nashville, TN 37232 USA

3D Reconstruction Surgical Video Understanding Trajectory Inference Surgical Instrument Tracking

May 21, 2026

OSS: Open Suturing Skills Vision-Based Assessment Challenge 2024-2025

Achieving high levels of surgical skill through effective training is essential for optimal patient outcomes. Automated, data-driven skill assessment holds significant potential to improve surgical training. While machine learning-based methods are increasingly popular for assessing skills in minimally invasive surgery, their application to open surgery remains limited. We present the results of a dedicated MICCAI challenge designed to benchmark and advance vision-based skill assessment in open surgery. The challenge dataset comprises videos of an open suturing training task recorded with a static GoPro camera in a dry-lab setting, with instrument trajectories available in addition to the primary video modality. The OSS Challenge was hosted over two consecutive years, comprising two and three independent tasks, respectively: (1) classifying skill level into four classes, (2) predicting the full Objective Structured Assessment of Technical Skills across eight categories, and (3) tracking hands and surgical tools. Participants submitted diverse solutions including deep learning-based video models, tracking-driven methods, and hybrid approaches. General-purpose spatiotemporal video models consistently achieved the strongest performance, though conceptually diverse approaches reached competitive levels when well-executed. Predicting fine-grained OSATS scores remains challenging but benefits substantially from increased training data. Keypoint tracking proves difficult given frequent occlusions and out-of-frame instances, limiting current applicability for motion-based skill analysis. This work benchmarks innovative and diverse solutions for surgical skill assessment, highlighting both the promise and current limitations of video-based evaluation in open surgery and identifying critical directions for advancing automated skill assessment toward clinical impact.

Hanna Hoffmann, Setareh Bady, Claas de Boer +54

Surgical Instrument Tracking Surgical Video Understanding

Mar 26, 2026

Towards Comprehensive Real-Time Scene Understanding in Ophthalmic Surgery through Multimodal Image Fusion

Purpose: The integration of multimodal imaging into operating rooms paves the way for comprehensive surgical scene understanding. In ophthalmic surgery, by now, two complementary imaging modalities are available: operating microscope (OPMI) imaging and real-time intraoperative optical coherence tomography (iOCT). This first work toward temporal OPMI and iOCT feature fusion demonstrates the potential of multimodal image processing for multi-head prediction through the example of precise instrument tracking in vitreoretinal surgery. Methods: We propose a multimodal, temporal, real-time capable network architecture to perform joint instrument detection, keypoint localization, and tool-tissue distance estimation. Our network design integrates a cross-attention fusion module to merge OPMI and iOCT image features, which are efficiently extracted via a YoloNAS and a CNN encoder, respectively. Furthermore, a region-based recurrent module leverages temporal coherence. Results: Our experiments demonstrate reliable instrument localization and keypoint detection (95.79% mAP50) and show that the incorporation of iOCT significantly improves tool-tissue distance estimation, while achieving real-time processing rates of 22.5 ms per frame. Especially for close distances to the retina (below 1 mm), the distance estimation accuracy improved from 284

μm

(OPMI only) to 33

μm

(multimodal). Conclusion: Feature fusion of multimodal imaging can enhance multi-task prediction accuracy compared to single-modality processing and real-time processing performance can be achieved through tailored network design. While our results demonstrate the potential of multi-modal processing for image-guided vitreoretinal surgery, they also underline key challenges that motivate future research toward more reliable, consistent, and comprehensive surgical scene understanding.

Nikolo Rohrmoser, Ghazal Ghazaei, Michael Sommersperger +1

Chair for Computer Aided Medical Procedures, Technical University of Munich, Garching, Germany. · Corporate Research and Technology, Carl Zeiss AG, Munich, Germany.

Surgical Instrument Tracking Medical Image Analysis Ophthalmic Image Analysis Surgical Video Understanding Multi-Source Image Fusion

Mar 26, 2026

Training-free Detection and 6D Pose Estimation of Unseen Surgical Instruments

Purpose: Accurate detection and 6D pose estimation of surgical instruments are crucial for many computer-assisted interventions. However, supervised methods lack flexibility for new or unseen tools and require extensive annotated data. This work introduces a training-free pipeline for accurate multi-view 6D pose estimation of unseen surgical instruments, which only requires a textured CAD model as prior knowledge. Methods: Our pipeline consists of two main stages. First, for detection, we generate object mask proposals in each view and score their similarity to rendered templates using a pre-trained feature extractor. Detections are matched across views, triangulated into 3D instance candidates, and filtered using multi-view geometric consistency. Second, for pose estimation, a set of pose hypotheses is iteratively refined and scored using feature-metric scores with cross-view attention. The best hypothesis undergoes a final refinement using a novel multi-view, occlusion-aware contour registration, which minimizes reprojection errors of unoccluded contour points. Results: The proposed method was rigorously evaluated on real-world surgical data from the MVPSP dataset. The method achieves millimeter-accurate pose estimates that are on par with supervised methods under controlled conditions, while maintaining full generalization to unseen instruments. These results demonstrate the feasibility of training-free, marker-less detection and tracking in surgical scenes, and highlight the unique challenges in surgical environments. Conclusion: We present a novel and flexible pipeline that effectively combines state-of-the-art foundational models, multi-view geometry, and contour-based refinement for high-accuracy 6D pose estimation of surgical instruments without task-specific training. This approach enables robust instrument tracking and scene understanding in dynamic clinical environments.

Jonas Hein, Lilian Calvet, Matthias Seibold +3

University Hospital Balgrist, University of Zurich, Switzerland. · ETH Zurich, Switzerland.

Object Pose Estimation Surgical Instrument Tracking Object Detection

Mar 24, 2026

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

Reliable estimation of surgical needle 3D position and orientation is essential for autonomous robotic suturing, yet existing methods operate almost exclusively under stereoscopic vision. In monocular endoscopic settings, common in transendoscopic and intraluminal procedures, depth ambiguity and rotational symmetry render needle pose estimation inherently ill-posed, producing a multimodal distribution over feasible configurations, rather than a single, well-grounded estimate. We present PinPoint, a probabilistic variational inference framework that treats this ambiguity directly, maintaining a distribution of pose hypotheses rather than suppressing it. PinPoint combines monocular image observations with robot-grasp constraints through analytical geometric likelihoods with closed-form Jacobians. This framework enables efficient Gauss-Newton preconditioning in a Stein Variational Newton inference, where second-order particle transport deterministically moves particles toward high-probability regions while kernel-based repulsion preserves diversity in the multimodal structure. On real needle-tracking sequences, PinPoint reduces mean translational error by 80% (down to 1.00 mm) and rotational error by 78% (down to 13.80°) relative to a particle-filter baseline, with substantially better-calibrated uncertainty. On induced-rotation sequences, where monocular ambiguity is most severe, PinPoint maintains a bimodal posterior 84% of the time, almost three times the rate of the particle filter baseline, correctly preserving the alternative hypothesis rather than committing prematurely to one mode. Suturing experiments in ex vivo tissue demonstrate stable tracking through intermittent occlusion, with average errors during occlusion of 1.34 mm in translation and 19.18° in rotation, even when the needle is fully embedded.

Jesse F. d'Almeida, Tanner Watts, Susheela Sharma Stern +3

Department of Mechanical Engineering, Vanderbilt University, TN, USA. · Department of Electrical and Computer Engineering and Department of Computer Science, Vanderbilt University, TN, USA. · The Robotics Center and the Kahlert School of Computing, University of Utah, Salt Lake City, UT, USA.

Object Pose Estimation Surgical Instrument Tracking Surgical Robotics

Mar 24, 2026

Instrument-Splatting++: Towards Controllable Surgical Instrument Digital Twin Using Gaussian Splatting

High-quality and controllable digital twins of surgical instruments are critical for Real2Sim in robot-assisted surgery, as they enable realistic simulation, synthetic data generation, and perception learning under novel poses. We present Instrument-Splatting++, a monocular 3D Gaussian Splatting (3DGS) framework that reconstructs surgical instruments as a fully controllable Gaussian asset with high fidelity. Our pipeline starts with part-wise geometry pretraining that injects CAD priors into Gaussian primitives and equips the representation with part-aware semantic rendering. Built on the pretrained model, we propose a semantics-aware pose estimation and tracking (SAPET) method to recover per-frame 6-DoF pose and joint angles from unposed endoscopic videos, where a gripper-tip network trained purely from synthetic semantics provides robust supervision and a loose regularization suppresses singular articulations. Finally, we introduce Robust Texture Learning (RTL), which alternates pose refinement and robust appearance optimization, mitigating pose noise during texture learning. The proposed framework can perform pose estimation and learn realistic texture from unposed videos. We validate our method on sequences extracted from EndoVis17/18, SAR-RARP, and an in-house dataset, showing superior photometric quality and improved geometric accuracy over state-of-the-art baselines. We further demonstrate a downstream keypoint detection task where unseen-pose data augmentation from our controllable instrument Gaussian improves performance.

Shuojue Yang, Zijian Wu, Chengjiaao Liao +5

Department of Biomedical Engineering, National University of Singapore (NUS), Singapore. · Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, Canada · Department of Electrical and Computer Engineering, NUS.

Digital Twins 3D Gaussian Splatting Articulated Object Reconstruction Surgical Instrument Tracking Surgical Robotics Object Pose Estimation

Mar 17, 2026

Speak, Segment, Track, Navigate: An Interactive System for Video-Guided Skull-Base Surgery

We introduce a speech-guided embodied agent framework for video-guided skull base surgery that dynamically executes perception and image-guidance tasks in response to surgeon queries. The proposed system integrates natural language interaction with real-time visual perception directly on live intraoperative video streams, thereby enabling surgeons to request computational assistance without disengaging from operative tasks. Unlike conventional image-guided navigation systems that rely on external optical trackers and additional hardware setup, the framework operates purely on intraoperative video. The system begins with interactive segmentation and labeling of the surgical instrument. The segmented instrument is then used as a spatial anchor that is autonomously tracked in the video stream to support downstream workflows, including anatomical segmentation, interactive registration of preoperative 3D models, monocular video-based estimation of the surgical tool pose, and image guidance through real-time anatomical overlays. We evaluate the proposed system in video-guided skull base surgery scenarios and benchmark its tracking performance against a commercially available optical tracking system. Across three experimental trials, the hybrid vision-based method achieved a mean absolute tool-tip position error of 2.32 Plus/Minus 1.10 mm in the camera frame, with inter-frame yaw and pitch propagation discrepancies of 0.18 Plus/Minus 0.25° and 0.21 Plus/Minus 0.30°, respectively. The system completes tool segmentation and anatomy registration within approximately two minutes, substantially reducing setup complexity relative to conventional tracking workflows. These results demonstrate that speech-guided embodied agents can provide accurate spatial guidance while improving workflow integration and enabling rapid deployment of video-guided surgical systems.

Jecia Z. Y. Mao, Francis X. Creighton, Russell H. Taylor +1

Surgical Instrument Tracking Surgical Video Understanding Surgical Robotics Object Pose Estimation

Mar 12, 2026

Real-time Rendering-based Surgical Instrument Tracking via Evolutionary Optimization

Accurate and efficient tracking of surgical instruments is fundamental for Robot-Assisted Minimally Invasive Surgery. Although vision-based robot pose estimation has enabled markerless calibration without tedious physical setups, reliable tool tracking for surgical robots still remains challenging due to partial visibility and specialized articulation design of surgical instruments. Previous works in the field are usually prone to unreliable feature detections under degraded visual quality and data scarcity, whereas rendering-based methods often struggle with computational costs and suboptimal convergence. In this work, we incorporate CMA-ES, an evolutionary optimization strategy, into a versatile tracking pipeline that jointly estimates surgical instrument pose and joint configurations. Using batch rendering to efficiently evaluate multiple pose candidates in parallel, the method significantly reduces inference time and improves convergence robustness. The proposed framework further generalizes to joint angle-free and bi-manual tracking settings, making it suitable for both vision feedback control and online surgery video calibration. Extensive experiments on synthetic and real-world datasets demonstrate that the proposed method significantly outperforms prior approaches in both accuracy and runtime. Source code and data are available at https://github.com/hanyang-hu/online_dvrk_tracking.

Hanyang Hu, Zekai Liang, Florian Richter +1

Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093 USA.

Visual Object Tracking Covariance Matrix Adaptation Evolution Strategy Object Pose Estimation Surgical Instrument Tracking Surgical Video Understanding Surgical Robotics

Mar 9, 2026

Extend Your Horizon: A Device-Agnostic Surgical Tool Tracking Framework with Multi-View Optimization for Augmented Reality

Surgical navigation provides real-time guidance by estimating the pose of patient anatomy and surgical instruments to visualize relevant intraoperative information. In conventional systems, instruments are typically tracked using fiducial markers and stationary optical tracking systems (OTS). Augmented reality (AR) has further enabled intuitive visualization and motivated tracking using sensors embedded in head-mounted displays (HMDs). However, most existing approaches rely on a clear line of sight, which is difficult to maintain in dynamic operating room environments due to frequent occlusions caused by equipment, surgical tools, and personnel. This work introduces a framework for tracking surgical instruments under occlusion by fusing multiple sensing modalities within a dynamic scene graph representation. The proposed approach integrates tracking systems with different accuracy levels and motion characteristics while estimating tracking reliability in real time. Experimental results demonstrate improved robustness and enhanced consistency of AR visualization in the presence of occlusions.

Jiaming Zhang, Mingxu Liu, Hongchao Shu +6

Johns Hopkins University · Johns Hopkins University, School of Medicine · University of Arkansas, Johns Hopkins University

Augmented Reality Surgical Instrument Tracking AR in Surgery Visual Object Tracking Multimodal Sensor Fusion Surgical Robotics