The Centre has a long history of developing new techniques for medical imaging (particularly in magnetic resonance imaging), transforming them from a primarily diagnostic modality into an interventional and therapeutic platform. This is facilitated by the Centre's strong engineering background in practical imaging and image analysis platform development, as well as advances in minimal access and robotic assisted surgery. Hamlyn has a strong tradition in pursuing basic sciences and theoretical research, with a clear focus on clinical translation.

In response to the current paradigm shift and clinical demand in bringing cellular and molecular imaging modalities to an in vivo – in situ setting during surgical intervention, our recent research has also been focussed on novel biophotonics platforms that can be used for real-time tissue characterisation, functional assessment, and intraoperative guidance during minimally invasive surgery. This includes, for example, SMART confocal laser endomicroscopy, time-resolved fluorescence spectroscopy and flexible FLIM catheters.


BibTex format

author = {Davids, J and Makariou, S-G and Ashrafian, H and Darzi, A and Marcus, HJ and Giannarou, S},
doi = {10.1016/j.wneu.2021.01.117},
journal = {World Neurosurg},
pages = {e669--e686},
title = {Automated Vision-Based Microsurgical Skill Analysis in Neurosurgery Using Deep Learning: Development and Preclinical Validation.},
url = {},
volume = {149},
year = {2021}

RIS format (EndNote, RefMan)

AB - BACKGROUND/OBJECTIVE: Technical skill acquisition is an essential component of neurosurgical training. Educational theory suggests that optimal learning and improvement in performance depends on the provision of objective feedback. Therefore, the aim of this study was to develop a vision-based framework based on a novel representation of surgical tool motion and interactions capable of automated and objective assessment of microsurgical skill. METHODS: Videos were obtained from 1 expert, 6 intermediate, and 12 novice surgeons performing arachnoid dissection in a validated clinical model using a standard operating microscope. A mask region convolutional neural network framework was used to segment the tools present within the operative field in a recorded video frame. Tool motion analysis was achieved using novel triangulation metrics. Performance of the framework in classifying skill levels was evaluated using the area under the curve and accuracy. Objective measures of classifying the surgeons' skill level were also compared using the Mann-Whitney U test, and a value of P < 0.05 was considered statistically significant. RESULTS: The area under the curve was 0.977 and the accuracy was 84.21%. A number of differences were found, which included experts having a lower median dissector velocity (P = 0.0004; 190.38 ms-1 vs. 116.38 ms-1), and a smaller inter-tool tip distance (median 46.78 vs. 75.92; P = 0.0002) compared with novices. CONCLUSIONS: Automated and objective analysis of microsurgery is feasible using a mask region convolutional neural network, and a novel tool motion and interaction representation. This may support technical skills training and assessment in neurosurgery.
AU - Davids,J
AU - Makariou,S-G
AU - Ashrafian,H
AU - Darzi,A
AU - Marcus,HJ
AU - Giannarou,S
DO - 10.1016/j.wneu.2021.01.117
EP - 686
PY - 2021///
SP - 669
TI - Automated Vision-Based Microsurgical Skill Analysis in Neurosurgery Using Deep Learning: Development and Preclinical Validation.
T2 - World Neurosurg
UR -
UR -
VL - 149
ER -