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Surgical scene understanding is a key barrier for situation-aware robotic surgeries and the associated surgical training. With the presence of domain shifts and the inclusion of new instruments and tissues, learning domain generalization (DG) plays a pivotal role in expanding instrument–tissue interaction detection to new domains in robotic surgery. Mimicking the ability of humans to incrementally learn new skills without forgetting their old skills in a similar domain, we employ incremental DG on scene graphs to predict instrument–tissue interaction during robot-assisted surgery. To achieve incremental DG, incorporate incremental learning (IL) to accommodate new instruments and knowledge-distillation-based student–teacher learning to tackle domain shifts in the new domain. Additionally, we designed an enhanced curriculum by smoothing (E-CBS) based on Laplacian of Gaussian (LoG) and Gaussian kernels, and integrated it with the feature extraction network (FEN) and graph network to improve the instrument–tissue interaction performance. Furthermore, the FEN’s and graph network’s logits are normalized by temperature normalization (T-Norm), and its effect in model calibration was studied. Quantitative and qualitative analysis proved that our incrementally-domain generalized interaction detection model was able to adapt to the target domain (transoral robotic surgery) while retaining its performance in the source domain (nephrectomy surgery). Additionally, the graph model enhanced by E-CBS and T-Norm outperformed other state-of-the-art models, and the incremental DG technique performed better than the naive domain adaption and DG technique.

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