Shifted Window Temporal Transformer for YOLO-Guided Phase Recognition in Laparoscopic Cholecystectomy Surgery

Sheekar Banerjee, Md. Shahabuddin, Md. Mahbub Hasan Akash, Nabilah, Mohammad Arafat Hussain

Intelligent operating rooms require accurate awareness of surgical workflow for better intra-operative decisions, teamwork, and surgical documentation. Therefore, accurately recognizing surgical phase during surgery is crucial. However, previous artificial intelligence-based methods provide fluctuating predictions for the transitions, restricting their clinical use. To address this challenge, we propose a clinically meaningful framework that integrates a Swin Transformer and Temporal Transformer Encoder (TTE) for effective surgical phase recognition and a parallel YOLOv11s network for real-time surgical instrument localization. To avoid phase flickering and to produce stable workflow predictions, a causal temporal smoothing is applied. The proposed framework is tested on the Cholec80 dataset for the simultaneous recognition of the surgical phases and instruments. The overall phase recognition accuracy of this model was 92%, and the macro average F1-score was 0.86. This performance surpasses CNN based methods such as EndoNet (81.7%) and SV-RCNet (85.3%), as well as temporal convolutional and transformer-based approaches including TeCNO (88.6%), Trans-SVNet (90.9%), and LoViT…