Action recognition is a prerequisite for many applications in laparoscopic video analysis including but not limited to surgical training, operation room planning, follow-up surgery preparation, post-operative surgical assessment, and surgical outcome estimation. However, automatic action recognition in laparoscopic surgeries involves numerous challenges such as (I) cross-action and intra-action duration variation, (II) relevant content distortion due to smoke, blood accumulation, fast camera motions, organ movements, object occlusion, and (III) surgical scene variations due to different illuminations and viewpoints. Besides, action annotations in laparoscopy surgeries are limited and expensive due to requiring expert knowledge. In this study, we design and evaluate a CNN-RNN architecture as well as a customized training-inference framework to deal with the mentioned challenges in laparoscopic surgery action recognition. Using stacked recurrent layers, our proposed network takes advantage of inter-frame dependencies to negate the negative effect of content distortion and variation in action recognition. Furthermore, our proposed frame sampling strategy effectively manages the duration variations in surgical actions to enable action recognition with high temporal resolution. Our extensive experiments confirm the superiority of our proposed method in action recognition compared to static CNNs.
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