Peer-Reviewed Publication
Med Image Anal2026;109103945.March 1, 2026Journal Article
Comparative validation of surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation in endoscopy: Results of the PhaKIR 2024 challenge.
Tobias Rueckert1, David Rauber2, Raphaela Maerkl2, Leonard Klausmann3, Suemeyye R Yildiran3, Max Gutbrod2, Danilo Weber Nunes2, Alvaro Fernandez Moreno4, Imanol Luengo5, Danail Stoyanov4, Nicolas Toussaint5, Enki Cho6, Hyeon Bae Kim6, Oh Sung Choo6, Ka Young Kim6, Seong Tae Kim6, Gonçalo Arantes7, Kehan Song8, Jianjun Zhu8, Junchen Xiong8, Tingyi Lin8, Shunsuke Kikuchi9, Hiroki Matsuzaki9, Atsushi Kouno9, João Renato Ribeiro Manesco10, João Paulo Papa10, Tae-Min Choi11, Tae Kyeong Jeong11, Juyoun Park11, Oluwatosin Alabi12, Meng Wei12, Tom Vercauteren12, Runzhi Wu13, Mengya Xu13, An Wang13, Long Bai13, Hongliang Ren13, Amine Yamlahi14, Jakob Hennighausen14, Lena Maier-Hein14, Satoshi Kondo15, Satoshi Kasai16, Kousuke Hirasawa17, Shu Yang18, Yihui Wang18, Hao Chen19, Santiago Rodríguez20, Nicolás Aparicio20, Leonardo Manrique20, Juan Camilo Lyons20, Olivia Hosie20, Nicolás Ayobi20, Pablo Arbeláez20, Yiping Li21, Yasmina Al Khalil21, Sahar Nasirihaghighi22, Stefanie Speidel23, Daniel Rueckert24, Hubertus Feussner25, Dirk Wilhelm25, Christoph Palm3
1Regensburg Medical Image Computing (ReMIC), OTH Regensburg, Regensburg, Germany; AKTORmed Robotic Surgery, Neutraubling, Germany; Research Group MITI, TUM University Hospital, School of Medicine and Health, Technical University of Munich, Munich, Germany. Electronic address: tobias.rueckert@re-mic.de.
2Regensburg Medical Image Computing (ReMIC), OTH Regensburg, Regensburg, Germany.
3Regensburg Medical Image Computing (ReMIC), OTH Regensburg, Regensburg, Germany; Regensburg Center of Biomedical Engineering (RCBE), OTH Regensburg and Regensburg University, Regensburg, Germany; Regensburg Center of Health Sciences and Technology (RCHST), OTH Regensburg, Regensburg, Germany.
4AI Centre of Excellence, Medtronic Ltd., Watford, UK; Engineering Sciences, University College London, London, UK.
5AI Centre of Excellence, Medtronic Ltd., Watford, UK.
6Augmented Intelligence Lab, Kyung Hee University, Seoul, South Korea.
7University of Minho, Braga, Portugal.
8Hanglok Tech, Zhuhai City, China.
9Jmees Inc., Kashiwa City, Japan.
10School of Sciences, São Paulo State University (UNESP), Bauru, Brazil.
11KIST HARILAB, Center for Humanoid Research, Artificial Intelligence and Robot Institute, Korea Institute of Science and Technology (KIST), Seoul, South Korea.
12King's College London, London, UK.
13The Chinese University of Hong Kong, Hong Kong, China.
14Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany.
15Muroran Institute of Technology, Hokkaido, Japan.
16Niigata University of Health and Welfare, Niigata, Japan.
17Konica Minolta, Inc., Osaka, Japan.
18Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong, China.
19Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong, China; Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Hong Kong, China; HKUST Shenzhen-Hong Kong Collaborative Innovation Research Institute, Shenzhen, China.
20Center for Research and Formation in Artificial Intelligence (CinfonIA), Los Andes University, Bogota, Colombia.
21Department of Biomedical Engineering, Medical Image Analysis Group, Eindhoven University of Technology, Eindhoven, Netherlands.
22Department of Biomedical Engineering, Medical Image Analysis Group, Eindhoven University of Technology, Eindhoven, Netherlands; Institute of Information Technology (ITEC), Klagenfurt University, Klagenfurt, Austria.
23Center for Tactile Internet with Human-in-the-loop (CeTI), TU Dresden, Dresden, Germany; Department of Translational Surgical Oncology, National Center for Tumor Diseases (NCT/UCC), Partner Site Dresden, Dresden, Germany.
24Chair for AI in Healthcare and Medicine, Technical University of Munich (TUM) and TUM University Hospital, Munich, Germany; Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, UK.
25Research Group MITI, TUM University Hospital, School of Medicine and Health, Technical University of Munich, Munich, Germany; Department of Surgery, TUM University Hospital, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Abstract
Reliable recognition and localization of surgical instruments in endoscopic video recordings are foundational for a wide range of applications in computer- and robot-assisted minimally invasive surgery (RAMIS), including surgical training, skill assessment, and autonomous assistance. However, robust performance under real-world conditions remains a significant challenge. Incorporating surgical con…
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