DeSmoke-LAP: improved unpaired image-to-image translation for desmoking in laparoscopic surgery

Purpose Robotic-assisted laparoscopic surgery has become the trend in medicine thanks to its convenience and lower risk of infection against traditional open surgery. However, the visibility during these procedures may severely deteriorate due to electrocauterisation which generates smoke in the operating cavity. This decreased visibility hinders the procedural time and surgical performance. Recent deep learning-based techniques have shown the potential for smoke and glare removal, but few targets laparoscopic videos. Method We propose DeSmoke-LAP, a new method for removing smoke from real robotic laparoscopic hysterectomy videos. The proposed method is based on the unpaired image-to-image cycle-consistent generative adversarial network in which two novel loss functions, namely, inter-channel discrepancies and dark channel prior, are integrated to facilitate smoke removal while maintaining the true semantics and illumination of the scene. Results DeSmoke-LAP is compared with several state-of-the-art desmoking methods qualitatively and quantitatively using referenceless image quality metrics on 10 laparoscopic hysterectomy videos through 5-fold cross-validation. Conclusion DeSmoke-LAP outperformed existing methods and generated smoke-free images without applying ground truths (paired images) and atmospheric scattering model. This shows distinctive achievement in dehazing in surgery, even in scenarios with partial inhomogenenous smoke. Our code and hysterectomy dataset will be made publicly available at https://www.ucl. ac.uk/interventional-surgical-sciences/weiss-open-research/weiss-open-data-server/desmoke-lap.