Anatomy segmentation in laparoscopic surgery: Comparison of machine learning and human expertise - an experimental study

Research output: Contribution to journalResearch articleContributedpeer-review



BACKGROUND: Lack of anatomy recognition represents a clinically relevant risk in abdominal surgery. Machine learning (ML) methods can help identify visible patterns and risk structures; however, their practical value remains largely unclear.

MATERIALS AND METHODS: Based on a novel dataset of 13 195 laparoscopic images with pixel-wise segmentations of 11 anatomical structures, we developed specialized segmentation models for each structure and combined models for all anatomical structures using two state-of-the-art model architectures (DeepLabv3 and SegFormer) and compared segmentation performance of algorithms to a cohort of 28 physicians, medical students, and medical laypersons using the example of pancreas segmentation.

RESULTS: Mean Intersection-over-Union for semantic segmentation of intra-abdominal structures ranged from 0.28 to 0.83 and from 0.23 to 0.77 for the DeepLabv3-based structure-specific and combined models, and from 0.31 to 0.85 and from 0.26 to 0.67 for the SegFormer-based structure-specific and combined models, respectively. Both the structure-specific and the combined DeepLabv3-based models are capable of near-real-time operation, while the SegFormer-based models are not. All four models outperformed at least 26 out of 28 human participants in pancreas segmentation.

CONCLUSIONS: These results demonstrate that ML methods have the potential to provide relevant assistance in anatomy recognition in minimally invasive surgery in near-real-time. Future research should investigate the educational value and subsequent clinical impact of the respective assistance systems.


Original languageEnglish
Pages (from-to)2962-2974
Number of pages13
JournalInternational journal of surgery
Issue number10
Publication statusPublished - 1 Oct 2023

External IDs

PubMedCentral PMC10583931
Scopus 85168443721
ORCID /0000-0003-2265-4809/work/150884442



  • Humans, Machine Learning, Algorithms, Laparoscopy, Image Processing, Computer-Assisted/methods