Overview of the semi-synthetic generation method. We illustrate both the concept of source image and the process to generate semi-synthetic images. For an image to be considered as source image, it must fulfill two conditions. First, its labeling must be available or easier than a manual annotation of the tool in a real endoscopic image. Second, it must be a close approximation of a real clinical image so that when complementary source images are blended, the result is close to a real endoscopic image. The automatic segmentation of source images is hue-based for (detailed in section IV-C) and trivial for . We assume that the correct way to blend complementary source images to form a real clinical image is unknown. In this figure, three possible ways to do it are illustrated. A green arrow is shown to highlight a part of the semi-synthetically generated image, the border of the tool, and the tooltip itself, whose appearance differs depending on the choice of blending function (best viewed in the electronic version of the manuscript).