Artificial intelligence-assisted phase recognition and skill assessment in laparoscopic surgery: A systematic review

Wenqiang Liao ¹ Ying Zhu ² Hanwei Zhang ³ Dan Wang ² Lijun Zhang ⁴ Tianxiang Chen ⁵ Ru Zhou ¹ Zi Ye ^3*

• ¹ Department of Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ² Hangzhou Institute for Advanced Study, University of Chinese Academy of Science, Hangzhou, Jiangsu Province, China
• ³ Institute of Intelligent Software, Guangzhou 511458, China, Guangzhou, China
• ⁴ Institute of Software Chinese Academy of Sciences, 100190, Beijing, Beijing, China
• ⁵ School of Cyber Space and Technology, University of Science and Technology of China, Hefei 230026, China, Hefei, China

With the widespread adoption of minimally invasive surgery, laparoscopic surgery has been an essential component of modern surgical procedures. As key technologies, laparoscopic phase recognition and skill evaluation aim to identify different stages of the surgical process and assess surgeons' operational skills using automated methods. This, in turn, can improve the quality of surgery and the skill of surgeons. This review summarizes the progress of research in laparoscopic surgery, phase recognition, and skill evaluation. At first, the importance of laparoscopic surgery is introduced, clarifying the relationship between phase recognition, skill evaluation, and other surgical tasks. The publicly available surgical datasets for laparoscopic phase recognition tasks are then detailed. The review highlights the research methods that have exhibited superior performance in these public datasets and identifies common characteristics of these highperforming methods. Based on the insights obtained, the commonly used phase recognition research and surgical skill evaluation methods and models in this field are summarized. In addition, this study briefly outlines the standards and methods for evaluating laparoscopic surgical skills. Finally, an analysis of the difficulties researchers face and potential future development directions is presented. Moreover, this paper aims to provide valuable references for researchers, promoting further advancements in this domain.