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Background Surgical process modeling automatically identifies surgical phases, and further improvement in recognition accuracy is expected with deep learning. Surgical tool or time series information has been used to improve the recognition accuracy of a model. However, it is difficult to collect this information continuously intraoperatively. The present study aimed to develop a deep convolution neural network (CNN) model that correctly identifies the surgical phase during laparoscopic cholecystectomy (LC). Methods We divided LC into six surgical phases (P1–P6) and one redundant phase (P0). We prepared 115 LC videos and converted them to image frames at 3 fps. Three experienced doctors labeled the surgical phases in all image frames. Our deep CNN model was trained with 106 of the 115 annotation datasets and was evaluated with the remaining datasets. By depending on both the prediction probability and frequency for a certain period, we aimed for highly accurate surgical phase recognition in the operation room. Results Nine full LC videos were converted into image frames and were fed to our deep CNN model. The average accuracy, precision, and recall were 0.970, 0.855, and 0.863, respectively. Conclusion The deep learning CNN model in this study successfully identified both the six surgical phases and the redundant phase, P0, which may increase the versatility of the surgical process recognition model for clinical use. We believe that this model can be used in artificial intelligence for medical devices. The degree of recognition accuracy is expected to improve with developments in advanced deep learning algorithms.

Artificial intelligence software available for medical devices: surgical phase recognition in laparoscopic cholecystectomy