Systems, apparatus and methods for localizing and/or determining the relative position of surgical instruments during a surgical procedure are disclosed. A method includes capturing an image depicting at least a portion of a first surgical instrument disposed at a first position with respect to a target tissue, and at least a portion of a second surgical instrument disposed at a second position with respect to the target tissue, the second position different from the first position. The method includes transforming the image to a three-dimensional model so the first position of the portion of the first surgical instrument is rendered with the three-dimensional model, and the second position of the portion of the second surgical instrument is rendered with the three-dimensional model. The method includes calculating distance between the portion of the first surgical instrument and the portion of the second surgical instrument based on the three dimensional model.