Using deep learning to identify the recurrent laryngeal nerve during thyroidectomy (Scientific Reports 2021)


Surgeons must visually distinguish soft-tissues, such as nerves, from surrounding anatomy to prevent complications and optimize patient outcomes. An accurate nerve segmentation and analysis tool could provide useful insight for surgical decision-making. Here, we present an end-to-end, automatic deep learning computer vision algorithm to segment and measure nerves. Unlike traditional medical imaging, our unconstrained setup with accessible handheld digital cameras, along with the unstructured open surgery scene, makes this task uniquely challenging. We investigate one common procedure, thyroidectomy, during which surgeons must avoid damaging the recurrent laryngeal nerve (RLN), which is responsible for human speech. We evaluate our segmentation algorithm on a diverse dataset across varied and challenging settings of operating room image capture, and show strong segmentation performance in the optimal image capture condition. This work lays the foundation for future research in real-time tissue discrimination and integration of accessible, intelligent tools into open surgery to provide actionable insights.

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Citation (bibtex)

  author = {Gong, Julia and Holsinger, F. Christopher and Noel, Julia E. and Mitani, Sohei and Jopling, Jeff and Bedi, Nikita and Koh, Yoon Woo and Orloff, Lisa A. and Cernea, Claudio R. and Yeung, Serena},
  title = {Using deep learning to identify the recurrent laryngeal nerve during thyroidectomy},
  booktitle = {Scientific Reports},
  month = {July},
  year = {2021}


This work was completed at Stanford MARVL. It was made possible by the Isackson Family Fund for Research in Head and Neck Surgery. We also thank Dr. Joy Wu and her Lab in the Division of Endocrinology, Stanford University.

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