A Standardized Temporal Segmentation Framework and Annotation Resource Library in Robotic Surgery
Bibliographic record
Abstract
Objective: To develop and share the first clinical temporal annotation guide library for 10 robotic procedures accompanied with a standardized ontology framework for surgical video annotation. Patients and Methods: A standardized temporal annotation framework of surgical videos paired with consistent, procedure-specific annotation guides is critical to enable comparisons of surgical insights and facilitate large-scale insights for exceptional surgical practice. Existing ontologies and guidance not only provide foundational frameworks but also provide limited scalability in clinical settings. Building on these, we developed a temporal annotation framework with nested surgical phases, steps, tasks, and subtasks. Procedure-specific annotation resource guides consistent with this framework that define each surgical segment with formulaic start and stop parameters and surgical objectives were iteratively created across 7 years (January 1, 2018, to January 1, 2025) through global research collaborations with surgeon researchers and industry scientists. Results: We provide the first resource library of annotation guides for 10 common robotic procedures consistent with our proposed temporal annotation framework, enabling consistent annotations for clinicians and large-scale data comparisons with computer-readable examples. These have been used in over 13,000 annotated surgical cases globally, demonstrating reproducibility and broad applicability. Conclusion: This resource library and accompanying ontology framework provide critical structure for standardized temporal segmentation in robotic surgery. This framework has been applied globally in private studies examining surgical objective performance metrics, surgical education, workflow characterization, outcome prediction, algorithms for surgical activity recognition, and more. Adoption of these resources will unify clinical, academic, and industry efforts, ultimately catalyzing transformational advancements in surgical practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.045 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.012 | 0.006 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.007 | 0.011 |
| Open science | 0.005 | 0.010 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.012 | 0.011 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".