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Purpose <p>Surgical workflow recognition enables context-aware assistance and skill assessment in computer-assisted interventions. Despite recent advances, current methods suffer from two critical challenges: prediction jitter across consecutive frames and poor discrimination of ambiguous phases. This paper aims to develop a stable framework by selectively propagating reliable historical information and explicitly modeling uncertainty for hard sample enhancement.</p> Methods <p>We propose a dual-pathway framework DSTED with Reliable Memory Propagation (RMP) and Uncertainty-Aware Prototype Retrieval (UPR). RMP maintains temporal coherence by filtering and fusing high-confidence historical features through multi-criteria reliability assessment. UPR constructs learnable class-specific prototypes from high-uncertainty samples and performs adaptive prototype matching to refine ambiguous frame representations. Finally, a confidence-driven gate dynamically balances both pathways based on prediction certainty.</p> Results <p>Our method achieves state-of-the-art performance on AutoLaparo-hysterectomy with 84.36% accuracy and 65.51% F1-score, surpassing the second-best method by 3.51% and 4.88%, respectively. Ablations reveal complementary gains from RMP (2.19%) and UPR (1.93%), with synergistic effects when combined. Extensive analysis confirms substantial reduction in temporal jitter and marked improvement on challenging phase transitions.</p> Conclusions <p>Our dual-pathway design introduces a novel paradigm for stable workflow recognition, demonstrating that decoupling the modeling of temporal consistency and phase ambiguity yields superior performance and clinical applicability.</p>

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DSTED: decoupling temporal stabilization and discriminative enhancement for surgical workflow recognition

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月25日

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  • Yueyao Chen,
  • Kai-Ni Wang,
  • Dario Tayupo,
  • Arnaud Huaulmé,
  • Krystel Nyangoh Timoh,
  • Pierre Jannin,
  • Qi Dou

摘要

Purpose

Surgical workflow recognition enables context-aware assistance and skill assessment in computer-assisted interventions. Despite recent advances, current methods suffer from two critical challenges: prediction jitter across consecutive frames and poor discrimination of ambiguous phases. This paper aims to develop a stable framework by selectively propagating reliable historical information and explicitly modeling uncertainty for hard sample enhancement.

Methods

We propose a dual-pathway framework DSTED with Reliable Memory Propagation (RMP) and Uncertainty-Aware Prototype Retrieval (UPR). RMP maintains temporal coherence by filtering and fusing high-confidence historical features through multi-criteria reliability assessment. UPR constructs learnable class-specific prototypes from high-uncertainty samples and performs adaptive prototype matching to refine ambiguous frame representations. Finally, a confidence-driven gate dynamically balances both pathways based on prediction certainty.

Results

Our method achieves state-of-the-art performance on AutoLaparo-hysterectomy with 84.36% accuracy and 65.51% F1-score, surpassing the second-best method by 3.51% and 4.88%, respectively. Ablations reveal complementary gains from RMP (2.19%) and UPR (1.93%), with synergistic effects when combined. Extensive analysis confirms substantial reduction in temporal jitter and marked improvement on challenging phase transitions.

Conclusions

Our dual-pathway design introduces a novel paradigm for stable workflow recognition, demonstrating that decoupling the modeling of temporal consistency and phase ambiguity yields superior performance and clinical applicability.