RAUL: Reference-Assisted Ureteroscopy Localization for Skill Assessment

2026-09-16

AI Summary

为解决输尿管镜手术中导航不全问题，本文提出RAUL方法，通过视频重建输尿管镜轨迹以评估不同经验水平外科医生的技能。

Abstract

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.

Problem

• ureteroscopy
• skill assessment
• anatomy navigation

Innovation

• RAUL
• reference-assisted reconstruction
• ureteroscope trajectories
• skill assessment
• video-only recovery