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Hongliang Ren

Hongliang Ren contributes to research discovery and scholarly infrastructure.

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Computer Vision eess.IV Robotics Artificial Intelligence Machine Learning

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preprint2026arXiv

A Real-time Scale-robust Network for Glottis Segmentation in Nasal Transnasal Intubation

Nasotracheal intubation (NTI) is a critical clinical procedure for establishing and maintaining patient airway patency. Machine-assisted NTI has emerged as a pivotal approach for optimizing procedural efficiency and minimizing manual intervention. However, visual detection algorithms employed for NTI navigation encounter significant challenges, including complex anatomical environments and suboptimal illumination conditions surrounding the glottis. Additionally, the glottis presents considerable scale variability throughout the procedure, initially appearing as a small, difficult-to-capture structure before expanding to occupy nearly the entire field of view. Moreover, traditional visual detection methods often have high computational costs, making real-time, high-precision detection on portable devices challenging. To enhance NTI efficacy and address these challenges, this paper proposes a novel glottis segmentation framework optimized for vision-assisted NTI applications. First, we designed a lightweight, multi-receptive field feature extraction module to reduce intra-class differences, achieving robustness to scale variations of the glottis. This module was then stacked to form the backbone and neck of our network. Subsequently, we developed an advanced label assignment method and redefined the number of samples to further reduce intra-class differences and enhance accuracy in the complex NTI environment. Experiments on three distinct datasets demonstrate that our network surpasses state-of-the-art algorithms, achieving a segmentation mDice of 92.9\% with a compact model size of 19 MB and an inference speed exceeding 170 frames per second. % Our code and datasets will be open-sourced on GitHub after the manuscript is accepted. Our code and datasets are available at https://github.com/HBUT-CV/GlottisNet.

preprint2026arXiv

CoGE: Sim-to-Real Online Geometric Estimation for Monocular Colonoscopy

Geometric estimation including depth estimation and scene reconstruction is a crucial technique for colonoscopy which can provide surgeons with 3D spatial perception and navigation. However, geometric ground truth in colonoscopy is difficult to obtain due to narrow and enclosed space of the colon, while there is a large feature gap between simulated data and realistic data caused by artifacts and illumination. In this paper, we present CoGE, a novel framework for online monocular geometric estimation during colonoscopy. Firstly, we propose an illumination-aware supervision module based on the Retinex theory to address illumination diversity in different colonoscopy scenes. Moreover, a structure-aware perception module is proposed based on wavelet decomposition to extract common structural and local features of the colon. Both quantitative and qualitative results demonstrate that the proposed model solely trained on simulated data achieves state-of-the-art performance in geometric estimation for both simulated and realistic scenes.

preprint2026arXiv

EndoGSim: Physics-Aware 4D Dynamic Endoscopic Scene Simulations via MLLM-Guided Gaussian Splatting

In robot-assisted minimally invasive surgery, high-fidelity dynamic endoscopic scene reconstruction and simulation are crucial to enhancing downstream tasks and advancing surgical outcomes. However, existing methods primarily focus on visual reconstruction, lacking physics-based descriptions of the scene required for realistic simulation. We propose a unified framework that achieves physics-aware reconstruction and physical simulation of endoscopic scenes through Multi-modal Large Language Models (MLLMs)-guided Gaussian Splatting. Our approach utilizes 4D Gaussian Splatting (4DGS) integrated with pre-trained segmentation and depth estimation to represent deformable tissues and tools. To achieve automatic inference of physical properties, we introduce an object-wise material field that initializes material parameters via MLLM and refines them through a differentiable Material Point Method (MPM) under joint supervision from rendered images and optical flow. Validated on both open-source and in-house datasets, our framework achieves superior simulation fidelity and physical accuracy compared to state-of-the-art methods, underscoring its potential to advance robot-assisted surgical applications.

preprint2022arXiv

A Miniature 3-DoF Flexible Parallel Robotic Wrist Using NiTi Wires for Gastrointestinal Endoscopic Surgery

Gastrointestinal endoscopic surgery (GES) has high requirements for instruments' size and distal dexterity, because of the narrow endoscopic channel and long, tortuous human gastrointestinal tract. This paper utilized Nickel-Titanium (NiTi) wires to develop a miniature 3-DoF (pitch-yaw-translation) flexible parallel robotic wrist (FPRW). Additionally, we assembled an electric knife on the wrist's connection interface and then teleoperated it to perform an endoscopic submucosal dissection (ESD) on porcine stomachs. The effective performance in each ESD workflow proves that the designed FPRW has sufficient workspace, high distal dexterity, and high positioning accuracy.

preprint2022arXiv

Class Balanced PixelNet for Neurological Image Segmentation

In this paper, we propose an automatic brain tumor segmentation approach (e.g., PixelNet) using a pixel-level convolutional neural network (CNN). The model extracts feature from multiple convolutional layers and concatenate them to form a hyper-column where samples a modest number of pixels for optimization. Hyper-column ensures both local and global contextual information for pixel-wise predictors. The model confirms the statistical efficiency by sampling a few pixels in the training phase where spatial redundancy limits the information learning among the neighboring pixels in conventional pixel-level semantic segmentation approaches. Besides, label skewness in training data leads the convolutional model often converge to certain classes which is a common problem in the medical dataset. We deal with this problem by selecting an equal number of pixels for all the classes in sampling time. The proposed model has achieved promising results in brain tumor and ischemic stroke lesion segmentation datasets.

preprint2022arXiv

Global-Reasoned Multi-Task Learning Model for Surgical Scene Understanding

Global and local relational reasoning enable scene understanding models to perform human-like scene analysis and understanding. Scene understanding enables better semantic segmentation and object-to-object interaction detection. In the medical domain, a robust surgical scene understanding model allows the automation of surgical skill evaluation, real-time monitoring of surgeon's performance and post-surgical analysis. This paper introduces a globally-reasoned multi-task surgical scene understanding model capable of performing instrument segmentation and tool-tissue interaction detection. Here, we incorporate global relational reasoning in the latent interaction space and introduce multi-scale local (neighborhood) reasoning in the coordinate space to improve segmentation. Utilizing the multi-task model setup, the performance of the visual-semantic graph attention network in interaction detection is further enhanced through global reasoning. The global interaction space features from the segmentation module are introduced into the graph network, allowing it to detect interactions based on both node-to-node and global interaction reasoning. Our model reduces the computation cost compared to running two independent single-task models by sharing common modules, which is indispensable for practical applications. Using a sequential optimization technique, the proposed multi-task model outperforms other state-of-the-art single-task models on the MICCAI endoscopic vision challenge 2018 dataset. Additionally, we also observe the performance of the multi-task model when trained using the knowledge distillation technique. The official code implementation is made available in GitHub.

preprint2022arXiv

Ischemic Stroke Lesion Segmentation Using Adversarial Learning

Ischemic stroke occurs through a blockage of clogged blood vessels supplying blood to the brain. Segmentation of the stroke lesion is vital to improve diagnosis, outcome assessment and treatment planning. In this work, we propose a segmentation model with adversarial learning for ischemic lesion segmentation. We adopt U-Net with skip connection and dropout as segmentation baseline network and a fully connected network (FCN) as discriminator network. Discriminator network consists of 5 convolution layers followed by leaky-ReLU and an upsampling layer to rescale the output to the size of the input map. Training a segmentation network along with an adversarial network can detect and correct higher order inconsistencies between the segmentation maps produced by ground-truth and the Segmentor. We exploit three modalities (CT, DPWI, CBF) of acute computed tomography (CT) perfusion data provided in ISLES 2018 (Ischemic Stroke Lesion Segmentation) for ischemic lesion segmentation. Our model has achieved dice accuracy of 42.10% with the cross-validation of training and 39% with the testing data.

preprint2022arXiv

RASEC: Rescaling Acquisition Strategy with Energy Constraints under SE-OU Fusion Kernel for Active Trachea Palpation and Incision Recommendation in Laryngeal Region

A novel palpation-based incision detection strategy in the laryngeal region, potentially for robotic tracheotomy, is proposed in this letter. A tactile sensor is introduced to measure tissue hardness in the specific laryngeal region by gentle contact. The kernel fusion method is proposed to combine the Squared Exponential (SE) kernel with Ornstein-Uhlenbeck (OU) kernel to figure out the drawbacks that the existing kernel functions are not sufficiently optimal in this scenario. Moreover, we further regularize exploration factor and greed factor, and the tactile sensor's moving distance and the robotic base link's rotation angle during the incision localization process are considered as new factors in the acquisition strategy. We conducted simulation and physical experiments to compare the newly proposed algorithm - Rescaling Acquisition Strategy with Energy Constraints (RASEC) in trachea detection with current palpation-based acquisition strategies. The result indicates that the proposed acquisition strategy with fusion kernel can successfully localize the incision with the highest algorithm performance (Average Precision 0.932, Average Recall 0.973, Average F1 score 0.952). During the robotic palpation process, the cumulative moving distance is reduced by 50%, and the cumulative rotation angle is reduced by 71.4% with no sacrifice in the comprehensive performance capabilities. Therefore, it proves that RASEC can efficiently suggest the incision zone in the laryngeal region and greatly reduced the energy loss.

preprint2022arXiv

Rethinking Surgical Captioning: End-to-End Window-Based MLP Transformer Using Patches

Surgical captioning plays an important role in surgical instruction prediction and report generation. However, the majority of captioning models still rely on the heavy computational object detector or feature extractor to extract regional features. In addition, the detection model requires additional bounding box annotation which is costly and needs skilled annotators. These lead to inference delay and limit the captioning model to deploy in real-time robotic surgery. For this purpose, we design an end-to-end detector and feature extractor-free captioning model by utilizing the patch-based shifted window technique. We propose Shifted Window-Based Multi-Layer Perceptrons Transformer Captioning model (SwinMLP-TranCAP) with faster inference speed and less computation. SwinMLP-TranCAP replaces the multi-head attention module with window-based multi-head MLP. Such deployments primarily focus on image understanding tasks, but very few works investigate the caption generation task. SwinMLP-TranCAP is also extended into a video version for video captioning tasks using 3D patches and windows. Compared with previous detector-based or feature extractor-based models, our models greatly simplify the architecture design while maintaining performance on two surgical datasets. The code is publicly available at https://github.com/XuMengyaAmy/SwinMLP_TranCAP.

preprint2022arXiv

Rethinking Surgical Instrument Segmentation: A Background Image Can Be All You Need

Data diversity and volume are crucial to the success of training deep learning models, while in the medical imaging field, the difficulty and cost of data collection and annotation are especially huge. Specifically in robotic surgery, data scarcity and imbalance have heavily affected the model accuracy and limited the design and deployment of deep learning-based surgical applications such as surgical instrument segmentation. Considering this, we rethink the surgical instrument segmentation task and propose a one-to-many data generation solution that gets rid of the complicated and expensive process of data collection and annotation from robotic surgery. In our method, we only utilize a single surgical background tissue image and a few open-source instrument images as the seed images and apply multiple augmentations and blending techniques to synthesize amounts of image variations. In addition, we also introduce the chained augmentation mixing during training to further enhance the data diversities. The proposed approach is evaluated on the real datasets of the EndoVis-2018 and EndoVis-2017 surgical scene segmentation. Our empirical analysis suggests that without the high cost of data collection and annotation, we can achieve decent surgical instrument segmentation performance. Moreover, we also observe that our method can deal with novel instrument prediction in the deployment domain. We hope our inspiring results will encourage researchers to emphasize data-centric methods to overcome demanding deep learning limitations besides data shortage, such as class imbalance, domain adaptation, and incremental learning. Our code is available at https://github.com/lofrienger/Single_SurgicalScene_For_Segmentation.

preprint2022arXiv

Surgical-VQA: Visual Question Answering in Surgical Scenes using Transformer

Visual question answering (VQA) in surgery is largely unexplored. Expert surgeons are scarce and are often overloaded with clinical and academic workloads. This overload often limits their time answering questionnaires from patients, medical students or junior residents related to surgical procedures. At times, students and junior residents also refrain from asking too many questions during classes to reduce disruption. While computer-aided simulators and recording of past surgical procedures have been made available for them to observe and improve their skills, they still hugely rely on medical experts to answer their questions. Having a Surgical-VQA system as a reliable 'second opinion' could act as a backup and ease the load on the medical experts in answering these questions. The lack of annotated medical data and the presence of domain-specific terms has limited the exploration of VQA for surgical procedures. In this work, we design a Surgical-VQA task that answers questionnaires on surgical procedures based on the surgical scene. Extending the MICCAI endoscopic vision challenge 2018 dataset and workflow recognition dataset further, we introduce two Surgical-VQA datasets with classification and sentence-based answers. To perform Surgical-VQA, we employ vision-text transformers models. We further introduce a residual MLP-based VisualBert encoder model that enforces interaction between visual and text tokens, improving performance in classification-based answering. Furthermore, we study the influence of the number of input image patches and temporal visual features on the model performance in both classification and sentence-based answering.

preprint2020arXiv

Learning and Reasoning with the Graph Structure Representation in Robotic Surgery

Learning to infer graph representations and performing spatial reasoning in a complex surgical environment can play a vital role in surgical scene understanding in robotic surgery. For this purpose, we develop an approach to generate the scene graph and predict surgical interactions between instruments and surgical region of interest (ROI) during robot-assisted surgery. We design an attention link function and integrate with a graph parsing network to recognize the surgical interactions. To embed each node with corresponding neighbouring node features, we further incorporate SageConv into the network. The scene graph generation and active edge classification mostly depend on the embedding or feature extraction of node and edge features from complex image representation. Here, we empirically demonstrate the feature extraction methods by employing label smoothing weighted loss. Smoothing the hard label can avoid the over-confident prediction of the model and enhances the feature representation learned by the penultimate layer. To obtain the graph scene label, we annotate the bounding box and the instrument-ROI interactions on the robotic scene segmentation challenge 2018 dataset with an experienced clinical expert in robotic surgery and employ it to evaluate our propositions.

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