Robustness of Convolutional Neural Networks for Surgical Tool Classification in Laparoscopic Videos from Multiple Sources and of Multiple Types: A Systematic Evaluation

Abstract

Deep learning approaches have been explored for surgical tool classification in laparoscopic videos. Convolutional neural networks (CNN) are prominent among the proposed approaches. However, concerns about the robustness and generalisability of CNN approaches have been raised. This paper evaluates CNN generalisability across different procedures and in data from different surgical settings. Moreover, generalisation performance to new types of procedures is assessed and insights are provided into the effect of increasing the size and representativeness of training data on the generalisation capabilities of CNN. Five experiments were conducted using three datasets. The DenseNet-121 model showed high generalisation capability within the dataset, with a mean average precision of 93%. However, the model performance diminished on data from different surgical sites and across procedure types (27% and 38%, respectively). The generalisation performance of the CNN model was improved by increasing the quantity of training videos on data of the same procedure type (the best improvement was 27%). These results highlight the importance of evaluating the performance of CNN models on data from unseen sources in order to determine their real classification capabilities. While the analysed CNN model yielded reasonably robust performance on data from different subjects, it showed a moderate reduction in performance for different surgical settings.