Abstract
PURPOSE: The principal objective of this study was to develop and evaluate a deep learning model for segmenting the common iliac vein (CIV) from intraoperative endoscopic videos during oblique lateral interbody fusion for L5/S1 (OLIF51), a minimally invasive surgical procedure for degenerative lumbosacral spine diseases. The study aimed to address the challenge of intraoperative differentiation of the CIV from surrounding tissues to minimize the risk of vascular damage during the surgery. METHODS: We employed two convolutional neural network (CNN) architectures: U-Net and U-Net++ with a ResNet18 backbone, for semantic segmentation. Gamma correction was applied during image preprocessing to improve luminance contrast between the CIV and adjacent tissues. We used a dataset of 614 endoscopic images from OLIF51 surgeries for model training, validation, and testing. RESULTS: The U-Net++/ResNet18 model outperformed, achieving a Dice score of 0.70, indicating superior ability in delineating the position and shape of the CIV compared to the U-Net/ResNet18 model, which achieved a Dice score of 0.59. Gamma correction increased the differentiation between the CIV and the artery, improving the Dice score from 0.44 to 0.70. CONCLUSION: The findings demonstrate that deep learning models, especially the U-Net++ with ResNet18 enhanced by gamma correction preprocessing, can effectively segment the CIV in intraoperative videos. This approach has the potential to significantly improve intraoperative assistance and reduce the risk of vascular injury during OLIF51 procedures, despite the need for further research and refinement of the model for clinical application.