Daily Papers

Lattice surgery with two-dimensional quantum error correcting codes is among the leading schemes for fault-tolerant quantum computation, motivated by superconducting hardware architectures. In conventional lattice surgery compilation schemes, logical circuits are compiled following a place-and-route paradigm, where logical qubits remain statically fixed in space throughout the computation. In this work, we introduce a paradigm shift by exploiting movable logical qubits via teleportation during the logical lattice surgery CNOT gate. Focusing on lattice surgery with the color code, we propose a proof-of-concept compilation scheme that leverages this capability. Numerical simulations show that the proposed approach can substantially reduce the routed circuit depth compared to standard place-and-route compilation techniques. Our results demonstrate that optimizations based on movable logical qubits are not limited to architectures with physically movable qubits, such as neutral atoms or trapped ions - they are also readily applicable to superconducting quantum hardware. An open-source implementation of our method is available on GitHub https://github.com/munich-quantum-toolkit/qecc.

Color codes are promising alternatives to surface codes for universal fault-tolerant quantum computing due to their simpler lattice-surgery protocols and the transversal implementation of logical Clifford gates. However, their practical deployment has been limited by slower decoding algorithms and worse logical failure rates and thresholds compared to surface codes. Although AI-based logical-flip decoders have recently been proposed to address these challenges, no clear framework currently exists for implementing such decoders within the parallel block-wise decoding schemes in both space and time required for large-scale fault-tolerant computation. AI-based pre-decoders offer a scalable alternative due to their local nature. By performing spacelike corrections on physical qubits and timelike corrections on stabilizer measurements, pre-decoders are naturally compatible with parallel block-wise decoding schemes and lattice-surgery protocols. In this work, we introduce AI-based pre-decoders for triangular color codes. We present a novel neural-network architecture for their implementation and develop methods to simplify the complex training data generated by color-code syndrome-extraction circuits containing feedforward operations. Remarkably, we find that both logical failure rates (LERs) and runtimes improve relative to raw Chromobius decoding as the code distance increases. For example, at code distance d=31 and physical error rate p=0.3%, our pre-decoder + Chromobius pipeline improves the logical failure rate by a factor of 347x while reducing runtime by 7.33x compared to raw Chromobius decoding alone. These results demonstrate that AI-based pre-decoding can substantially narrow the performance gap between color codes and surface codes, bringing color codes closer to practical large-scale fault-tolerant quantum computation.

Lattices are architected metamaterials whose properties strongly depend on their geometrical design. The analogy between lattices and graphs enables the use of graph neural networks (GNNs) as a faster surrogate model compared to traditional methods such as finite element modelling. In this work, we generate a big dataset of structure-property relationships for strut-based lattices. The dataset is made available to the community which can fuel the development of methods anchored in physical principles for the fitting of fourth-order tensors. In addition, we present a higher-order GNN model trained on this dataset. The key features of the model are (i) SE(3) equivariance, and (ii) consistency with the thermodynamic law of conservation of energy. We compare the model to non-equivariant models based on a number of error metrics and demonstrate its benefits in terms of predictive performance and reduced training requirements. Finally, we demonstrate an example application of the model to an architected material design task. The methods which we developed are applicable to fourth-order tensors beyond elasticity such as piezo-optical tensor etc.

We present LATTICE, a new framework for high-fidelity 3D asset generation that bridges the quality and scalability gap between 3D and 2D generative models. While 2D image synthesis benefits from fixed spatial grids and well-established transformer architectures, 3D generation remains fundamentally more challenging due to the need to predict both spatial structure and detailed geometric surfaces from scratch. These challenges are exacerbated by the computational complexity of existing 3D representations and the lack of structured and scalable 3D asset encoding schemes. To address this, we propose VoxSet, a semi-structured representation that compresses 3D assets into a compact set of latent vectors anchored to a coarse voxel grid, enabling efficient and position-aware generation. VoxSet retains the simplicity and compression advantages of prior VecSet methods while introducing explicit structure into the latent space, allowing positional embeddings to guide generation and enabling strong token-level test-time scaling. Built upon this representation, LATTICE adopts a two-stage pipeline: first generating a sparse voxelized geometry anchor, then producing detailed geometry using a rectified flow transformer. Our method is simple at its core, but supports arbitrary resolution decoding, low-cost training, and flexible inference schemes, achieving state-of-the-art performance on various aspects, and offering a significant step toward scalable, high-quality 3D asset creation.

Generalized code surgery is a versatile and low-overhead technique for performing fault-tolerant computation on quantum low-density parity-check (qLDPC) codes. In many settings, surgery exhibits practical space overheads, while its time overhead remains a bottleneck at O(d) syndrome rounds per operation. In this work, we construct surgery gadgets that perform parallel logical measurements on 2D hypergraph product codes in constant time overhead (O(1)) and near-constant space overhead (O(1)). The reduced time overhead is a result of amortization, as we show, following the formulation by Cowtan et al. (arXiv:2510.14895), that performing d surgery operations in O(d) time is fault tolerant. Our gadgets combine the strengths of different approaches to fault-tolerant logical operations: they partially retain the flexibility of surgery while achieving overheads comparable to transversal gates. Consequently, they are well-suited for near-term experimental realization and demonstrate new possibilities in the design of gadgets for fast logical computation.

This study presents a computational optimisation framework of a hip implant through the development of a functionally graded biomimetic lattice structure, whose design was structurally optimised to limit stress shielding. The optimisation technique was inspired by the inverse of a bone remodelling algorithm, promoting an even stress distribution throughout the design region, by reducing the density and consequently the stiffness, in regions where strain energy was higher than the reference level. The result of the optimisation technique provided a non-uniform graded density distribution field that showed lower density level on the sides of the implant stem, and higher material density around the medial axis of the stem. The optimised material distribution was captured using mapping of a triply periodic minimal surface lattice structure on the implant, which resulted in porous lattice surfaces inside the solid implant. The performance of the porous implant design was evaluated through implementation of a finite element bone remodelling algorithm and comparing the bone response with a femur with fully solid implant model, in terms of stress distribution and mass change. The results of the analysis showed improved bone formation on the bone-implant interface, and enhanced stress transmission to the surrounding bone from the implant.

Lattice-based planning techniques simplify the motion planning problem for autonomous vehicles by limiting available motions to a pre-computed set of primitives. These primitives are then combined online to generate more complex maneuvers. A set of motion primitives t-span a lattice if, given a real number t at least 1, any configuration in the lattice can be reached via a sequence of motion primitives whose cost is no more than a factor of t from optimal. Computing a minimal t-spanning set balances a trade-off between computed motion quality and motion planning performance. In this work, we formulate this problem for an arbitrary lattice as a mixed integer linear program. We also propose an A*-based algorithm to solve the motion planning problem using these primitives. Finally, we present an algorithm that removes the excessive oscillations from planned motions -- a common problem in lattice-based planning. Our method is validated for autonomous driving in both parking lot and highway scenarios.

Recent advances in robot-assisted surgery have resulted in progressively more precise, efficient, and minimally invasive procedures, sparking a new era of robotic surgical intervention. This enables doctors, in collaborative interaction with robots, to perform traditional or minimally invasive surgeries with improved outcomes through smaller incisions. Recent efforts are working toward making robotic surgery more autonomous which has the potential to reduce variability of surgical outcomes and reduce complication rates. Deep reinforcement learning methodologies offer scalable solutions for surgical automation, but their effectiveness relies on extensive data acquisition due to the absence of prior knowledge in successfully accomplishing tasks. Due to the intensive nature of simulated data collection, previous works have focused on making existing algorithms more efficient. In this work, we focus on making the simulator more efficient, making training data much more accessible than previously possible. We introduce Surgical Gym, an open-source high performance platform for surgical robot learning where both the physics simulation and reinforcement learning occur directly on the GPU. We demonstrate between 100-5000x faster training times compared with previous surgical learning platforms. The code is available at: https://github.com/SamuelSchmidgall/SurgicalGym.

Realistic surgical simulation plays a crucial role in training novice surgeons and in the development of autonomous agents. World models can scale such simulation environments to realistic and diverse procedures by predicting future patient states conditioned on current observations and surgical actions. However, current state-of-the-art approaches often fail to satisfy key criteria required for clinical applicability, including visual realism, physically grounded interactions, and the ability to simulate scenarios beyond the training distribution. Hence, we introduce SWoMo, a neuro-symbolic world model for cataract surgery simulation that decouples motion generation from visual realism. The symbolic component, consisting of a rule-based simulator and scene graph representations, models motion dynamics and tool-tissue interactions, while a diffusion model produces realistic visual appearance, including textures and tissue deformations. We propose an inverse pairing strategy that reconstructs real surgical videos in the simulator to obtain paired simulated and real videos, which are then used to train our video diffusion model for the reverse objective of sim-to-real translation. Our experiments show both qualitative and quantitative improvements over prior work. We demonstrate that our simulator further satisfies the key criteria, including generalisation to unseen interaction geometries, improvements in downstream phase detection, and unsupervised video style transfer. The code, data, and model weights are available at: https://ssharvienkumar.github.io/SWoMo/

Recent research has been increasingly focusing on developing 3D world models that simulate complex real-world scenarios. World models have found broad applications across various domains, including embodied AI, autonomous driving, entertainment, etc. A more realistic simulation with accurate physics will effectively narrow the sim-to-real gap and allow us to gather rich information about the real world conveniently. While traditional manual modeling has enabled the creation of virtual 3D scenes, modern approaches have leveraged advanced machine learning algorithms for 3D world generation, with most recent advances focusing on generative methods that can create virtual worlds based on user instructions. This work explores such a research direction by proposing LatticeWorld, a simple yet effective 3D world generation framework that streamlines the industrial production pipeline of 3D environments. LatticeWorld leverages lightweight LLMs (LLaMA-2-7B) alongside the industry-grade rendering engine (e.g., Unreal Engine 5) to generate a dynamic environment. Our proposed framework accepts textual descriptions and visual instructions as multimodal inputs and creates large-scale 3D interactive worlds with dynamic agents, featuring competitive multi-agent interaction, high-fidelity physics simulation, and real-time rendering. We conduct comprehensive experiments to evaluate LatticeWorld, showing that it achieves superior accuracy in scene layout generation and visual fidelity. Moreover, LatticeWorld achieves over a 90times increase in industrial production efficiency while maintaining high creative quality compared with traditional manual production methods. Our demo video is available at https://youtu.be/8VWZXpERR18

We give a simple, fully correct, and assumption-light replacement for the contested "domain-extension" in Step 9 of a recent windowed-QFT lattice algorithm with complex-Gaussian windows~chen2024quantum. The published Step~9 suffers from a periodicity/support mismatch. We present a pair-shift difference construction that coherently cancels all unknown offsets, produces an exact uniform CRT-coset state over Z_{P}, and then uses the QFT to enforce the intended modular linear relation. The unitary is reversible, uses poly(log M_2) gates, and preserves the algorithm's asymptotics. Project Page: https://github.com/yifanzhang-pro/quantum-lattice.

Recent advances in 3D X-ray Computed Tomographic (CT) sensors have stimulated research efforts to unveil the extremely complex micro-scale processes that control the activity of soil microorganisms. Voxel-based description (up to hundreds millions voxels) of the pore space can be extracted, from grey level 3D CT scanner images, by means of simple image processing tools. Classical methods for numerical simulation of biological dynamics using mesh of voxels, such as Lattice Boltzmann Model (LBM), are too much time consuming. Thus, the use of more compact and reliable geometrical representations of pore space can drastically decrease the computational cost of the simulations. Several recent works propose basic analytic volume primitives (e.g. spheres, generalized cylinders, ellipsoids) to define a piece-wise approximation of pore space for numerical simulation of draining, diffusion and microbial decomposition. Such approaches work well but the drawback is that it generates approximation errors. In the present work, we study another alternative where pore space is described by means of geometrically relevant connected subsets of voxels (regions) computed from the curvilinear skeleton. Indeed, many works use the curvilinear skeleton (3D medial axis) for analyzing and partitioning 3D shapes within various domains (medicine, material sciences, petroleum engineering, etc.) but only a few ones in soil sciences. Within the context of soil sciences, most studies dealing with 3D medial axis focus on the determination of pore throats. Here, we segment pore space using curvilinear skeleton in order to achieve numerical simulation of microbial decomposition (including diffusion processes). We validate simulation outputs by comparison with other methods using different pore space geometrical representations (balls, voxels).

In this paper we introduce learnable lattice vector quantization and demonstrate its effectiveness for learning discrete representations. Our method, termed LL-VQ-VAE, replaces the vector quantization layer in VQ-VAE with lattice-based discretization. The learnable lattice imposes a structure over all discrete embeddings, acting as a deterrent against codebook collapse, leading to high codebook utilization. Compared to VQ-VAE, our method obtains lower reconstruction errors under the same training conditions, trains in a fraction of the time, and with a constant number of parameters (equal to the embedding dimension D), making it a very scalable approach. We demonstrate these results on the FFHQ-1024 dataset and include FashionMNIST and Celeb-A.

As deep learning models scale, managing, inspecting, and modifying large checkpoints has become increasingly challenging. Researchers often need to alter model weights for layer restructuring, precision casting, low-rank factorization, and architectural debugging, yet these workflows often rely on fragile ad-hoc Python scripts. Here, we introduce BrainSurgery, a tool for robust and reproducible "tensor surgery" on neural network checkpoints, and provide a system demonstration covering four examples and three case studies from model upcycling to LoRA extraction. By abstracting storage formats and memory management, BrainSurgery executes complex transformations through declarative YAML plans. It supports structural modifications, mathematical transformations, and tensor reshaping through expressive regex and structural targeting, while built-in assertions validate tensor shapes, data types, and values to prevent silent errors. We envision that BrainSurgery will provide a strong foundation for future research through its reproducible and validated operations.

Research on autonomous surgery has largely focused on simple task automation in controlled environments. However, real-world surgical applications demand dexterous manipulation over extended durations and generalization to the inherent variability of human tissue. These challenges remain difficult to address using existing logic-based or conventional end-to-end learning approaches. To address this gap, we propose a hierarchical framework for performing dexterous, long-horizon surgical steps. Our approach utilizes a high-level policy for task planning and a low-level policy for generating robot trajectories. The high-level planner plans in language space, generating task-level or corrective instructions that guide the robot through the long-horizon steps and correct for the low-level policy's errors. We validate our framework through ex vivo experiments on cholecystectomy, a commonly-practiced minimally invasive procedure, and conduct ablation studies to evaluate key components of the system. Our method achieves a 100\% success rate across eight unseen ex vivo gallbladders, operating fully autonomously without human intervention. This work demonstrates step-level autonomy in a surgical procedure, marking a milestone toward clinical deployment of autonomous surgical systems.

In robot-assisted minimally invasive surgery, high-fidelity dynamic endoscopic scene reconstruction and simulation are crucial to enhancing downstream tasks and advancing surgical outcomes. However, existing methods primarily focus on visual reconstruction, lacking physics-based descriptions of the scene required for realistic simulation. We propose a unified framework that achieves physics-aware reconstruction and physical simulation of endoscopic scenes through Multi-modal Large Language Models (MLLMs)-guided Gaussian Splatting. Our approach utilizes 4D Gaussian Splatting (4DGS) integrated with pre-trained segmentation and depth estimation to represent deformable tissues and tools. To achieve automatic inference of physical properties, we introduce an object-wise material field that initializes material parameters via MLLM and refines them through a differentiable Material Point Method (MPM) under joint supervision from rendered images and optical flow. Validated on both open-source and in-house datasets, our framework achieves superior simulation fidelity and physical accuracy compared to state-of-the-art methods, underscoring its potential to advance robot-assisted surgical applications.

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

Surgical simulation offers a promising addition to conventional surgical training. However, available simulation tools lack photorealism and rely on hardcoded behaviour. Denoising Diffusion Models are a promising alternative for high-fidelity image synthesis, but existing state-of-the-art conditioning methods fall short in providing precise control or interactivity over the generated scenes. We introduce SurGrID, a Scene Graph to Image Diffusion Model, allowing for controllable surgical scene synthesis by leveraging Scene Graphs. These graphs encode a surgical scene's components' spatial and semantic information, which are then translated into an intermediate representation using our novel pre-training step that explicitly captures local and global information. Our proposed method improves the fidelity of generated images and their coherence with the graph input over the state-of-the-art. Further, we demonstrate the simulation's realism and controllability in a user assessment study involving clinical experts. Scene Graphs can be effectively used for precise and interactive conditioning of Denoising Diffusion Models for simulating surgical scenes, enabling high fidelity and interactive control over the generated content.

While foundation models have advanced surgical video analysis, current approaches rely predominantly on pixel-level reconstruction objectives that waste model capacity on low-level visual details - such as smoke, specular reflections, and fluid motion - rather than semantic structures essential for surgical understanding. We present UniSurg, a video-native foundation model that shifts the learning paradigm from pixel-level reconstruction to latent motion prediction. Built on the Video Joint Embedding Predictive Architecture (V-JEPA), UniSurg introduces three key technical innovations tailored to surgical videos: 1) motion-guided latent prediction to prioritize semantically meaningful regions, 2) spatiotemporal affinity self-distillation to enforce relational consistency, and 3) feature diversity regularization to prevent representation collapse in texture-sparse surgical scenes. To enable large-scale pretraining, we curate UniSurg-15M, the largest surgical video dataset to date, comprising 3,658 hours of video from 50 sources across 13 anatomical regions. Extensive experiments across 17 benchmarks demonstrate that UniSurg significantly outperforms state-of-the-art methods on surgical workflow recognition (+14.6% F1 on EgoSurgery, +10.3% on PitVis), action triplet recognition (39.54% mAP-IVT on CholecT50), skill assessment, polyp segmentation, and depth estimation. These results establish UniSurg as a new standard for universal, motion-oriented surgical video understanding.

We propose using Normalizing Flows as a trainable kernel within the molecular dynamics update of Hamiltonian Monte Carlo (HMC). By learning (invertible) transformations that simplify our dynamics, we can outperform traditional methods at generating independent configurations. We show that, using a carefully constructed network architecture, our approach can be easily scaled to large lattice volumes with minimal retraining effort. The source code for our implementation is publicly available online at https://github.com/nftqcd/fthmc.

Surgical simulation plays a pivotal role in training novice surgeons, accelerating their learning curve and reducing intra-operative errors. However, conventional simulation tools fall short in providing the necessary photorealism and the variability of human anatomy. In response, current methods are shifting towards generative model-based simulators. Yet, these approaches primarily focus on using increasingly complex conditioning for precise synthesis while neglecting the fine-grained human control aspect. To address this gap, we introduce SG2VID, the first diffusion-based video model that leverages Scene Graphs for both precise video synthesis and fine-grained human control. We demonstrate SG2VID's capabilities across three public datasets featuring cataract and cholecystectomy surgery. While SG2VID outperforms previous methods both qualitatively and quantitatively, it also enables precise synthesis, providing accurate control over tool and anatomy's size and movement, entrance of new tools, as well as the overall scene layout. We qualitatively motivate how SG2VID can be used for generative augmentation and present an experiment demonstrating its ability to improve a downstream phase detection task when the training set is extended with our synthetic videos. Finally, to showcase SG2VID's ability to retain human control, we interact with the Scene Graphs to generate new video samples depicting major yet rare intra-operative irregularities.

We present FreeBird, an extensible Julia-based platform for computational studies of phase equilibria at generic interfaces. The package supports a range of system configurations, from atomistic solid surfaces to coarse-grained lattice-gas models, with energies evaluated using classical interatomic potentials or lattice Hamiltonians. Both atomistic and lattice systems accommodate single- or multi-component mixtures with flexibly definable surface and lattice geometries. Implemented sampling algorithms include nested sampling, Wang-Landau sampling, Metropolis Monte Carlo, and, for tractable lattice systems, exact enumeration. Leveraging Julia's type hierarchies and multiple dispatch, FreeBird provides a modular interface that allows seamless integration of system definitions, energy evaluators, and sampling schemes. Designed for flexibility, extensibility, and performance, FreeBird offers a versatile framework for exploring the thermodynamics of interfacial phenomena.

Dynamic reconstruction of deformable tissues in endoscopic video is a key technology for robot-assisted surgery. Recent reconstruction methods based on neural radiance fields (NeRFs) have achieved remarkable results in the reconstruction of surgical scenes. However, based on implicit representation, NeRFs struggle to capture the intricate details of objects in the scene and cannot achieve real-time rendering. In addition, restricted single view perception and occluded instruments also propose special challenges in surgical scene reconstruction. To address these issues, we develop SurgicalGaussian, a deformable 3D Gaussian Splatting method to model dynamic surgical scenes. Our approach models the spatio-temporal features of soft tissues at each time stamp via a forward-mapping deformation MLP and regularization to constrain local 3D Gaussians to comply with consistent movement. With the depth initialization strategy and tool mask-guided training, our method can remove surgical instruments and reconstruct high-fidelity surgical scenes. Through experiments on various surgical videos, our network outperforms existing method on many aspects, including rendering quality, rendering speed and GPU usage. The project page can be found at https://surgicalgaussian.github.io.

Reconstruction of the soft tissues in robotic surgery from endoscopic stereo videos is important for many applications such as intra-operative navigation and image-guided robotic surgery automation. Previous works on this task mainly rely on SLAM-based approaches, which struggle to handle complex surgical scenes. Inspired by recent progress in neural rendering, we present a novel framework for deformable tissue reconstruction from binocular captures in robotic surgery under the single-viewpoint setting. Our framework adopts dynamic neural radiance fields to represent deformable surgical scenes in MLPs and optimize shapes and deformations in a learning-based manner. In addition to non-rigid deformations, tool occlusion and poor 3D clues from a single viewpoint are also particular challenges in soft tissue reconstruction. To overcome these difficulties, we present a series of strategies of tool mask-guided ray casting, stereo depth-cueing ray marching and stereo depth-supervised optimization. With experiments on DaVinci robotic surgery videos, our method significantly outperforms the current state-of-the-art reconstruction method for handling various complex non-rigid deformations. To our best knowledge, this is the first work leveraging neural rendering for surgical scene 3D reconstruction with remarkable potential demonstrated. Code is available at: https://github.com/med-air/EndoNeRF.

Non-parametric quantization has received much attention due to its efficiency on parameters and scalability to a large codebook. In this paper, we present a unified formulation of different non-parametric quantization methods through the lens of lattice coding. The geometry of lattice codes explains the necessity of auxiliary loss terms when training auto-encoders with certain existing lookup-free quantization variants such as BSQ. As a step forward, we explore a few possible candidates, including random lattices, generalized Fibonacci lattices, and densest sphere packing lattices. Among all, we find the Leech lattice-based quantization method, which is dubbed as Spherical Leech Quantization (Λ_{24}-SQ), leads to both a simplified training recipe and an improved reconstruction-compression tradeoff thanks to its high symmetry and even distribution on the hypersphere. In image tokenization and compression tasks, this quantization approach achieves better reconstruction quality across all metrics than BSQ, the best prior art, while consuming slightly fewer bits. The improvement also extends to state-of-the-art auto-regressive image generation frameworks.

Foundation models in video generation are demonstrating remarkable capabilities as potential world models for simulating the physical world. However, their application in high-stakes domains like surgery, which demand deep, specialized causal knowledge rather than general physical rules, remains a critical unexplored gap. To systematically address this challenge, we present SurgVeo, the first expert-curated benchmark for video generation model evaluation in surgery, and the Surgical Plausibility Pyramid (SPP), a novel, four-tiered framework tailored to assess model outputs from basic appearance to complex surgical strategy. On the basis of the SurgVeo benchmark, we task the advanced Veo-3 model with a zero-shot prediction task on surgical clips from laparoscopic and neurosurgical procedures. A panel of four board-certified surgeons evaluates the generated videos according to the SPP. Our results reveal a distinct "plausibility gap": while Veo-3 achieves exceptional Visual Perceptual Plausibility, it fails critically at higher levels of the SPP, including Instrument Operation Plausibility, Environment Feedback Plausibility, and Surgical Intent Plausibility. This work provides the first quantitative evidence of the chasm between visually convincing mimicry and causal understanding in surgical AI. Our findings from SurgVeo and the SPP establish a crucial foundation and roadmap for developing future models capable of navigating the complexities of specialized, real-world healthcare domains.

We examine in detail the accuracy, efficiency and implementation issues that arise when a simplified code structure is employed to evaluate the partition function of the two-dimensional square Ising model on periodic lattices though repeated tensor contractions.

I introduce a novel mathematical framework integrating topological dynamics, operator algebras, and ergodic geometry to study lattices of asynchronous metric dynamical systems. Each node in the lattice carries an internal flow represented by a one-parameter family of operators, evolving on its own time scale. I formalize stratified state spaces capturing multiple levels of synchronized behavior, define an asynchronous evolution metric that quantifies phase-offset distances between subsystems, and characterize emergent coherent topologies arising when subsystems synchronize. Within this framework, I develop formal operators for the evolution of each subsystem and give precise conditions under which phase-aligned synchronization occurs across the lattice. The main results include: (1) the existence and uniqueness of coherent (synchronized) states under a contractive coupling condition, (2) stability of these coherent states and criteria for their emergence as a collective phase transition in a continuous operator topology, and (3) the influence of symmetries, with group-invariant coupling leading to flow-invariant synchrony subspaces and structured cluster dynamics. Proofs are given for each theorem, demonstrating full mathematical rigor. In a final section, I discuss hypothetical applications of this framework to symbolic lattice systems (e.g. subshifts), to invariant group actions on dynamical lattices, and to operator fields over stratified manifolds in the spirit of noncommutative geometry. Throughout, I write in the first person to emphasize the exploratory nature of this work. The paper avoids any reference to cosmology or observers, focusing instead on clean, formal mathematics suitable for a broad array of dynamical systems.

This article presents a Monte Carlo study on bond percolation in distorted square and triangular lattices. The distorted lattices are generated by dislocating the sites from their regular positions. The amount and direction of the dislocations are random, but can be tuned by the distortion parameter α. Once the sites are dislocated, the bond lengths δ between the nearest neighbors change. A bond can only be occupied if its bond length is less than a threshold value called the connection threshold d. It is observed that when the connection threshold is greater than the lattice constant (assumed to be 1), the bond percolation threshold p_b always increases with distortion. For dle 1, no spanning configuration is found for the square lattice when the lattice is distorted, even very slightly. On the other hand, the triangular lattice not only spans for dle 1, it also shows a decreasing trend for p_b in the low-α range. These variation patterns have been linked with the average coordination numbers of the distorted lattices. A critical value d_c for the connection threshold has been defined as the value of d below which no spanning configuration can be found even after occupying all the bonds satisfying the connection criterion δle d. The behavior of d_c(α) is markedly different for the two lattices.

Multi-cellular robot design aims to create robots comprised of numerous cells that can be efficiently controlled to perform diverse tasks. Previous research has demonstrated the ability to generate robots for various tasks, but these approaches often optimize robots directly in the vast design space, resulting in robots with complicated morphologies that are hard to control. In response, this paper presents a novel coarse-to-fine method for designing multi-cellular robots. Initially, this strategy seeks optimal coarse-grained robots and progressively refines them. To mitigate the challenge of determining the precise refinement juncture during the coarse-to-fine transition, we introduce the Hyperbolic Embeddings for Robot Design (HERD) framework. HERD unifies robots of various granularity within a shared hyperbolic space and leverages a refined Cross-Entropy Method for optimization. This framework enables our method to autonomously identify areas of exploration in hyperbolic space and concentrate on regions demonstrating promise. Finally, the extensive empirical studies on various challenging tasks sourced from EvoGym show our approach's superior efficiency and generalization capability.

A new information theoretic condition is presented for reconstructing a discrete random variable X based on the knowledge of a set of discrete functions of X. The reconstruction condition is derived from Shannon's 1953 lattice theory with two entropic metrics of Shannon and Rajski. Because such a theoretical material is relatively unknown and appears quite dispersed in different references, we first provide a synthetic description (with complete proofs) of its concepts, such as total, common and complementary informations. Definitions and properties of the two entropic metrics are also fully detailed and shown compatible with the lattice structure. A new geometric interpretation of such a lattice structure is then investigated that leads to a necessary (and sometimes sufficient) condition for reconstructing the discrete random variable X given a set { X_1,ldots,X_{n} } of elements in the lattice generated by X. Finally, this condition is illustrated in five specific examples of perfect reconstruction problems: reconstruction of a symmetric random variable from the knowledge of its sign and absolute value, reconstruction of a word from a set of linear combinations, reconstruction of an integer from its prime signature (fundamental theorem of arithmetic) and from its remainders modulo a set of coprime integers (Chinese remainder theorem), and reconstruction of the sorting permutation of a list from a minimal set of pairwise comparisons.

The multi-task learning (MTL) paradigm aims to simultaneously learn multiple tasks within a single model capturing higher-level, more general hidden patterns that are shared by the tasks. In deep learning, a significant challenge in the backpropagation training process is the design of advanced optimisers to improve the convergence speed and stability of the gradient descent learning rule. In particular, in multi-task deep learning (MTDL) the multitude of tasks may generate potentially conflicting gradients that would hinder the concurrent convergence of the diverse loss functions. This challenge arises when the gradients of the task objectives have either different magnitudes or opposite directions, causing one or a few to dominate or to interfere with each other, thus degrading the training process. Gradient surgery methods address the problem explicitly dealing with conflicting gradients by adjusting the overall gradient trajectory. This work introduces a novel gradient surgery method, the Similarity-Aware Momentum Gradient Surgery (SAM-GS), which provides an effective and scalable approach based on a gradient magnitude similarity measure to guide the optimisation process. The SAM-GS surgery adopts gradient equalisation and modulation of the first-order momentum. A series of experimental tests have shown the effectiveness of SAM-GS on synthetic problems and MTL benchmarks. Gradient magnitude similarity plays a crucial role in regularising gradient aggregation in MTDL for the optimisation of the learning process.

Algorithms based on normalizing flows are emerging as promising machine learning approaches to sampling complicated probability distributions in a way that can be made asymptotically exact. In the context of lattice field theory, proof-of-principle studies have demonstrated the effectiveness of this approach for scalar theories, gauge theories, and statistical systems. This work develops approaches that enable flow-based sampling of theories with dynamical fermions, which is necessary for the technique to be applied to lattice field theory studies of the Standard Model of particle physics and many condensed matter systems. As a practical demonstration, these methods are applied to the sampling of field configurations for a two-dimensional theory of massless staggered fermions coupled to a scalar field via a Yukawa interaction.

We generalize the Hamiltonian Monte Carlo algorithm with a stack of neural network layers and evaluate its ability to sample from different topologies in a two dimensional lattice gauge theory. We demonstrate that our model is able to successfully mix between modes of different topologies, significantly reducing the computational cost required to generated independent gauge field configurations. Our implementation is available at https://github.com/saforem2/l2hmc-qcd .

Most studies on surgical activity recognition utilizing Artificial intelligence (AI) have focused mainly on recognizing one type of activity from small and mono-centric surgical video datasets. It remains speculative whether those models would generalize to other centers. In this work, we introduce a large multi-centric multi-activity dataset consisting of 140 videos (MultiBypass140) of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgeries performed at two medical centers: the University Hospital of Strasbourg (StrasBypass70) and Inselspital, Bern University Hospital (BernBypass70). The dataset has been fully annotated with phases and steps. Furthermore, we assess the generalizability and benchmark different deep learning models in 7 experimental studies: 1) Training and evaluation on BernBypass70; 2) Training and evaluation on StrasBypass70; 3) Training and evaluation on the MultiBypass140; 4) Training on BernBypass70, evaluation on StrasBypass70; 5) Training on StrasBypass70, evaluation on BernBypass70; Training on MultiBypass140, evaluation 6) on BernBypass70 and 7) on StrasBypass70. The model's performance is markedly influenced by the training data. The worst results were obtained in experiments 4) and 5) confirming the limited generalization capabilities of models trained on mono-centric data. The use of multi-centric training data, experiments 6) and 7), improves the generalization capabilities of the models, bringing them beyond the level of independent mono-centric training and validation (experiments 1) and 2)). MultiBypass140 shows considerable variation in surgical technique and workflow of LRYGB procedures between centers. Therefore, generalization experiments demonstrate a remarkable difference in model performance. These results highlight the importance of multi-centric datasets for AI model generalization to account for variance in surgical technique and workflows.

We develop a learning framework for building deformable templates, which play a fundamental role in many image analysis and computational anatomy tasks. Conventional methods for template creation and image alignment to the template have undergone decades of rich technical development. In these frameworks, templates are constructed using an iterative process of template estimation and alignment, which is often computationally very expensive. Due in part to this shortcoming, most methods compute a single template for the entire population of images, or a few templates for specific sub-groups of the data. In this work, we present a probabilistic model and efficient learning strategy that yields either universal or conditional templates, jointly with a neural network that provides efficient alignment of the images to these templates. We demonstrate the usefulness of this method on a variety of domains, with a special focus on neuroimaging. This is particularly useful for clinical applications where a pre-existing template does not exist, or creating a new one with traditional methods can be prohibitively expensive. Our code and atlases are available online as part of the VoxelMorph library at http://voxelmorph.csail.mit.edu.

Scalar quantization of large language models (LLMs) is fundamentally limited by information-theoretic bounds. While vector quantization (VQ) overcomes these limits by encoding blocks of parameters jointly, practical implementations must avoid the need for expensive lookup mechanisms or other explicit codebook storage. Lattice approaches address this through highly structured and dense packing. This paper explores the Leech lattice, which, with its optimal sphere packing and kissing configurations at 24 dimensions, is the highest dimensional lattice known with such optimal properties. To make the Leech lattice usable for LLM quantization, we extend an existing search algorithm based on the extended Golay code construction, to i) support indexing, enabling conversion to and from bitstrings without materializing the codebook, ii) allow angular search over union of Leech lattice shells, iii) propose fully-parallelisable dequantization kernel. Lastly, we provide a geometric reinterpretation of combining shape--gain quantization with GPTQ-style Hessian corrections: the standard scale-correction step of shape--gain acts as a retraction onto a product of spheres, yielding a Spherical GPTQ primarily acting on directions. We find that low-angular-distortion LLVQ reduces sensitivity to Hadamard/rotation preprocessing, and enables a strong Hadamard-free PTQ in practice. LLVQ delivers state-of-the-art LLM quantization performance, outperforming recent methods such as Quip\#, QTIP, and PVQ. The results highlight the effectiveness of high-dimensional lattices for scalable, theoretically grounded model compression.

The recovery of damaged or resected ribcage structures requires precise, custom-designed implants to restore the integrity and functionality of the thoracic cavity. Traditional implant design methods rely mainly on manual processes, making them time-consuming and susceptible to variability. In this work, we explore the feasibility of automated ribcage implant generation using deep learning. We present a framework based on 3D U-Net architecture that processes CT scans to generate patient-specific implant designs. To the best of our knowledge, this is the first investigation into automated thoracic implant generation using deep learning approaches. Our preliminary results, while moderate, highlight both the potential and the significant challenges in this complex domain. These findings establish a foundation for future research in automated ribcage reconstruction and identify key technical challenges that need to be addressed for practical implementation.

Multi-task learning (MTL) compresses the information from multiple tasks into a unified backbone to improve computational efficiency and generalization. Recent work directly merges multiple independently trained models to perform MTL instead of collecting their raw data for joint training, greatly expanding the application scenarios of MTL. However, by visualizing the representation distribution of existing model merging schemes, we find that the merged model often suffers from the dilemma of representation bias. That is, there is a significant discrepancy in the representation distribution between the merged and individual models, resulting in poor performance of merged MTL. In this paper, we propose a representation surgery solution called "Surgery" to reduce representation bias in the merged model. Specifically, Surgery is a lightweight task-specific module that takes the representation of the merged model as input and attempts to output the biases contained in the representation from the merged model. We then designed an unsupervised optimization objective that updates the Surgery module by minimizing the distance between the merged model's representation and the individual model's representation. Extensive experiments demonstrate significant MTL performance improvements when our Surgery module is applied to state-of-the-art (SOTA) model merging schemes.

In this work, we develop an open-source surgical simulation environment that includes a realistic model obtained by MRI-scanning a physical phantom, for the purpose of training and evaluating a Learning from Demonstration (LfD) algorithm for autonomous suturing. The LfD algorithm utilizes Dynamic Movement Primitives (DMP) and Locally Weighted Regression (LWR), but focuses on the needle trajectory, rather than the instruments, to obtain better generality with respect to needle grasps. We conduct a user study to collect multiple suturing demonstrations and perform a comprehensive analysis of the ability of the LfD algorithm to generalize from a demonstration at one location in one phantom to different locations in the same phantom and to a different phantom. Our results indicate good generalization, on the order of 91.5%, when learning from more experienced subjects, indicating the need to integrate skill assessment in the future.

In the realm of robot-assisted minimally invasive surgery, dynamic scene reconstruction can significantly enhance downstream tasks and improve surgical outcomes. Neural Radiance Fields (NeRF)-based methods have recently risen to prominence for their exceptional ability to reconstruct scenes but are hampered by slow inference speed, prolonged training, and inconsistent depth estimation. Some previous work utilizes ground truth depth for optimization but is hard to acquire in the surgical domain. To overcome these obstacles, we present Endo-4DGS, a real-time endoscopic dynamic reconstruction approach that utilizes 3D Gaussian Splatting (GS) for 3D representation. Specifically, we propose lightweight MLPs to capture temporal dynamics with Gaussian deformation fields. To obtain a satisfactory Gaussian Initialization, we exploit a powerful depth estimation foundation model, Depth-Anything, to generate pseudo-depth maps as a geometry prior. We additionally propose confidence-guided learning to tackle the ill-pose problems in monocular depth estimation and enhance the depth-guided reconstruction with surface normal constraints and depth regularization. Our approach has been validated on two surgical datasets, where it can effectively render in real-time, compute efficiently, and reconstruct with remarkable accuracy.

The segmentation of pelvic fracture fragments in CT and X-ray images is crucial for trauma diagnosis, surgical planning, and intraoperative guidance. However, accurately and efficiently delineating the bone fragments remains a significant challenge due to complex anatomy and imaging limitations. The PENGWIN challenge, organized as a MICCAI 2024 satellite event, aimed to advance automated fracture segmentation by benchmarking state-of-the-art algorithms on these complex tasks. A diverse dataset of 150 CT scans was collected from multiple clinical centers, and a large set of simulated X-ray images was generated using the DeepDRR method. Final submissions from 16 teams worldwide were evaluated under a rigorous multi-metric testing scheme. The top-performing CT algorithm achieved an average fragment-wise intersection over union (IoU) of 0.930, demonstrating satisfactory accuracy. However, in the X-ray task, the best algorithm achieved an IoU of 0.774, which is promising but not yet sufficient for intra-operative decision-making, reflecting the inherent challenges of fragment overlap in projection imaging. Beyond the quantitative evaluation, the challenge revealed methodological diversity in algorithm design. Variations in instance representation, such as primary-secondary classification versus boundary-core separation, led to differing segmentation strategies. Despite promising results, the challenge also exposed inherent uncertainties in fragment definition, particularly in cases of incomplete fractures. These findings suggest that interactive segmentation approaches, integrating human decision-making with task-relevant information, may be essential for improving model reliability and clinical applicability.

Recent advances in multimodal large language models (LLMs) have highlighted their potential for medical and surgical applications. However, existing surgical datasets predominantly adopt a Visual Question Answering (VQA) format with heterogeneous taxonomies and lack support for pixel-level segmentation, limiting consistent evaluation and applicability. We present SurgMLLMBench, a unified multimodal benchmark explicitly designed for developing and evaluating interactive multimodal LLMs for surgical scene understanding, including the newly collected Micro-surgical Artificial Vascular anastomosIS (MAVIS) dataset. It integrates pixel-level instrument segmentation masks and structured VQA annotations across laparoscopic, robot-assisted, and micro-surgical domains under a unified taxonomy, enabling comprehensive evaluation beyond traditional VQA tasks and richer visual-conversational interactions. Extensive baseline experiments show that a single model trained on SurgMLLMBench achieves consistent performance across domains and generalizes effectively to unseen datasets. SurgMLLMBench will be publicly released as a robust resource to advance multimodal surgical AI research, supporting reproducible evaluation and development of interactive surgical reasoning models.

There is great potential to apply machine learning in the area of numerical lattice quantum field theory, but full exploitation of that potential will require new strategies. In this white paper for the Snowmass community planning process, we discuss the unique requirements of machine learning for lattice quantum field theory research and outline what is needed to enable exploration and deployment of this approach in the future.

A lattice quantizer approximates an arbitrary real-valued source vector with a vector taken from a specific discrete lattice. The quantization error is the difference between the source vector and the lattice vector. In a classic 1996 paper, Zamir and Feder show that the globally optimal lattice quantizer (which minimizes the mean square error) has white quantization error: for a uniformly distributed source, the covariance of the error is the identity matrix, multiplied by a positive real factor. We generalize the theorem, showing that the same property holds (i) for any lattice whose mean square error cannot be decreased by a small perturbation of the generator matrix, and (ii) for an optimal product of lattices that are themselves locally optimal in the sense of (i). We derive an upper bound on the normalized second moment (NSM) of the optimal lattice in any dimension, by proving that any lower- or upper-triangular modification to the generator matrix of a product lattice reduces the NSM. Using these tools and employing the best currently known lattice quantizers to build product lattices, we construct improved lattice quantizers in dimensions 13 to 15, 17 to 23, and 25 to 48. In some dimensions, these are the first reported lattices with normalized second moments below the best known upper bound.

High-fidelity reconstruction of deformable tissues from endoscopic videos remains challenging due to the limitations of existing methods in capturing subtle color variations and modeling global deformations. While 3D Gaussian Splatting (3DGS) enables efficient dynamic reconstruction, its fixed per-Gaussian color assignment struggles with intricate textures, and linear deformation modeling fails to model consistent global deformation. To address these issues, we propose ColorGS, a novel framework that integrates spatially adaptive color encoding and enhanced deformation modeling for surgical scene reconstruction. First, we introduce Colored Gaussian Primitives, which employ dynamic anchors with learnable color parameters to adaptively encode spatially varying textures, significantly improving color expressiveness under complex lighting and tissue similarity. Second, we design an Enhanced Deformation Model (EDM) that combines time-aware Gaussian basis functions with learnable time-independent deformations, enabling precise capture of both localized tissue deformations and global motion consistency caused by surgical interactions. Extensive experiments on DaVinci robotic surgery videos and benchmark datasets (EndoNeRF, StereoMIS) demonstrate that ColorGS achieves state-of-the-art performance, attaining a PSNR of 39.85 (1.5 higher than prior 3DGS-based methods) and superior SSIM (97.25\%) while maintaining real-time rendering efficiency. Our work advances surgical scene reconstruction by balancing high fidelity with computational practicality, critical for intraoperative guidance and AR/VR applications.

Open procedures represent the dominant form of surgery worldwide. Artificial intelligence (AI) has the potential to optimize surgical practice and improve patient outcomes, but efforts have focused primarily on minimally invasive techniques. Our work overcomes existing data limitations for training AI models by curating, from YouTube, the largest dataset of open surgical videos to date: 1997 videos from 23 surgical procedures uploaded from 50 countries. Using this dataset, we developed a multi-task AI model capable of real-time understanding of surgical behaviors, hands, and tools - the building blocks of procedural flow and surgeon skill. We show that our model generalizes across diverse surgery types and environments. Illustrating this generalizability, we directly applied our YouTube-trained model to analyze open surgeries prospectively collected at an academic medical center and identified kinematic descriptors of surgical skill related to efficiency of hand motion. Our Annotated Videos of Open Surgery (AVOS) dataset and trained model will be made available for further development of surgical AI.

Surgical instrument segmentation under Federated Learning (FL) is a promising direction, which enables multiple surgical sites to collaboratively train the model without centralizing datasets. However, there exist very limited FL works in surgical data science, and FL methods for other modalities do not consider inherent characteristics in surgical domain: i) different scenarios show diverse anatomical backgrounds while highly similar instrument representation; ii) there exist surgical simulators which promote large-scale synthetic data generation with minimal efforts. In this paper, we propose a novel Personalized FL scheme, Spatio-Temporal Representation Decoupling and Enhancement (FedST), which wisely leverages surgical domain knowledge during both local-site and global-server training to boost segmentation. Concretely, our model embraces a Representation Separation and Cooperation (RSC) mechanism in local-site training, which decouples the query embedding layer to be trained privately, to encode respective backgrounds. Meanwhile, other parameters are optimized globally to capture the consistent representations of instruments, including the temporal layer to capture similar motion patterns. A textual-guided channel selection is further designed to highlight site-specific features, facilitating model adapta tion to each site. Moreover, in global-server training, we propose Synthesis-based Explicit Representation Quantification (SERQ), which defines an explicit representation target based on synthetic data to synchronize the model convergence during fusion for improving model generalization.

Since Isaac Newton first studied the Kissing Number Problem in 1694, determining the maximal number of non-overlapping spheres around a central sphere has remained a fundamental challenge. This problem is the local analogue of Hilbert's 18th problem, bridging geometry, number theory, and information theory. Although significant progress has been made through lattices and codes, the irregularities of high-dimensional geometry, dimensional structure variability, and combinatorial explosion beyond Go limit the scalability and generality of existing methods. Here we model the problem as a two-player matrix completion game and train the reinforcement learning system, PackingStar, to play the games. The matrix entries represent pairwise cosines of sphere center vectors. One player fills entries while another corrects suboptimal ones to improve exploration quality, cooperatively maximizing the matrix size, corresponding to the kissing number. These matrices are decomposed into representative substructures, providing diverse bases and structural constraints that steer subsequent games and make extremely large spaces tractable. PackingStar surpasses records from dimensions 25 to 31 and sets new lower bounds for generalized kissing numbers under various angular constraints. It achieves the first breakthrough beyond rational structures from 1971 in 13 dimensions and discovers over 6000 new structures in other dimensions. Notably, some configurations challenge long-held antipodal paradigms, revealing algebraic correspondences with finite simple groups as well as geometric relationships across dimensions. Inspired by these patterns, humans devised further improved constructions. These results demonstrate AI's power to explore high-dimensional spaces beyond human intuition via extreme-scale reinforcement learning and open new pathways for the Kissing Number Problem and broader geometry research.

Smoke generated by surgical instruments during laparoscopic surgery can obscure the visual field, impairing surgeons' ability to perform operations accurately and safely. Thus, smoke removal task for laparoscopic images is highly desirable. Despite laparoscopic image desmoking has attracted the attention of researchers in recent years and several algorithms have emerged, the lack of publicly available high-quality benchmark datasets is the main bottleneck to hamper the development progress of this task. To advance this field, we construct a new high-quality dataset for Laparoscopic Surgery image Desmoking, named LSD3K, consisting of 3,000 paired synthetic non-homogeneous smoke images. In this paper, we provide a dataset generation pipeline, which includes modeling smoke shape using Blender, collecting ground-truth images from the Cholec80 dataset, random sampling of smoke masks and etc. Based on the proposed benchmark, we further conducted a comprehensive evaluation of the existing representative desmoking algorithms. The proposed dataset is publicly available at https://drive.google.com/file/d/1v0U5_3S4nJpaUiP898Q0pc-MfEAtnbOq/view?usp=sharing

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

The field of surgical computer vision has undergone considerable breakthroughs in recent years with the rising popularity of deep neural network-based methods. However, standard fully-supervised approaches for training such models require vast amounts of annotated data, imposing a prohibitively high cost; especially in the clinical domain. Self-Supervised Learning (SSL) methods, which have begun to gain traction in the general computer vision community, represent a potential solution to these annotation costs, allowing to learn useful representations from only unlabeled data. Still, the effectiveness of SSL methods in more complex and impactful domains, such as medicine and surgery, remains limited and unexplored. In this work, we address this critical need by investigating four state-of-the-art SSL methods (MoCo v2, SimCLR, DINO, SwAV) in the context of surgical computer vision. We present an extensive analysis of the performance of these methods on the Cholec80 dataset for two fundamental and popular tasks in surgical context understanding, phase recognition and tool presence detection. We examine their parameterization, then their behavior with respect to training data quantities in semi-supervised settings. Correct transfer of these methods to surgery, as described and conducted in this work, leads to substantial performance gains over generic uses of SSL - up to 7.4% on phase recognition and 20% on tool presence detection - as well as state-of-the-art semi-supervised phase recognition approaches by up to 14%. Further results obtained on a highly diverse selection of surgical datasets exhibit strong generalization properties. The code is available at https://github.com/CAMMA-public/SelfSupSurg.

Purpose: General consensus amongst researchers and industry points to a lack of large, representative annotated datasets as the biggest obstacle to progress in the field of surgical data science. Self-supervised learning represents a solution to part of this problem, removing the reliance on annotations. However, the robustness of current self-supervised learning methods to domain shifts remains unclear, limiting our understanding of its utility for leveraging diverse sources of surgical data. Methods: In this work, we employ self-supervised learning to flexibly leverage diverse surgical datasets, thereby learning taskagnostic representations that can be used for various surgical downstream tasks. Based on this approach, to elucidate the impact of pre-training on downstream task performance, we explore 22 different pre-training dataset combinations by modulating three variables: source hospital, type of surgical procedure, and pre-training scale (number of videos). We then finetune the resulting model initializations on three diverse downstream tasks: namely, phase recognition and critical view of safety in laparoscopic cholecystectomy and phase recognition in laparoscopic hysterectomy. Results: Controlled experimentation highlights sizable boosts in performance across various tasks, datasets, and labeling budgets. However, this performance is intricately linked to the composition of the pre-training dataset, robustly proven through several study stages. Conclusion: The composition of pre-training datasets can severely affect the effectiveness of SSL methods for various downstream tasks and should critically inform future data collection efforts to scale the application of SSL methodologies. Keywords: Self-Supervised Learning, Transfer Learning, Surgical Computer Vision, Endoscopic Videos, Critical View of Safety, Phase Recognition

Endoscopic surgery relies on two-dimensional views, posing challenges for surgeons in depth perception and instrument manipulation. While Monocular Visual Simultaneous Localization and Mapping (MVSLAM) has emerged as a promising solution, its implementation in endoscopic procedures faces significant challenges due to hardware limitations, such as the use of a monocular camera and the absence of odometry sensors. This study presents BodySLAM, a robust deep learning-based MVSLAM approach that addresses these challenges through three key components: CycleVO, a novel unsupervised monocular pose estimation module; the integration of the state-of-the-art Zoe architecture for monocular depth estimation; and a 3D reconstruction module creating a coherent surgical map. The approach is rigorously evaluated using three publicly available datasets (Hamlyn, EndoSLAM, and SCARED) spanning laparoscopy, gastroscopy, and colonoscopy scenarios, and benchmarked against four state-of-the-art methods. Results demonstrate that CycleVO exhibited competitive performance with the lowest inference time among pose estimation methods, while maintaining robust generalization capabilities, whereas Zoe significantly outperformed existing algorithms for depth estimation in endoscopy. BodySLAM's strong performance across diverse endoscopic scenarios demonstrates its potential as a viable MVSLAM solution for endoscopic applications.

Surgical future prediction, driven by real-time AI analysis of surgical video, is critical for operating room safety and efficiency. It provides actionable insights into upcoming events, their timing, and risks-enabling better resource allocation, timely instrument readiness, and early warnings for complications (e.g., bleeding, bile duct injury). Despite this need, current surgical AI research focuses on understanding what is happening rather than predicting future events. Existing methods target specific tasks in isolation, lacking unified approaches that span both short-term (action triplets, events) and long-term horizons (remaining surgery duration, phase transitions). These methods rely on coarse-grained supervision while fine-grained surgical action triplets and steps remain underexplored. Furthermore, methods based only on future feature prediction struggle to generalize across different surgical contexts and procedures. We address these limits by reframing surgical future prediction as state-change learning. Rather than forecasting raw observations, our approach classifies state transitions between current and future timesteps. We introduce SurgFUTR, implementing this through a teacher-student architecture. Video clips are compressed into state representations via Sinkhorn-Knopp clustering; the teacher network learns from both current and future clips, while the student network predicts future states from current videos alone, guided by our Action Dynamics (ActDyn) module. We establish SFPBench with five prediction tasks spanning short-term (triplets, events) and long-term (remaining surgery duration, phase and step transitions) horizons. Experiments across four datasets and three procedures show consistent improvements. Cross-procedure transfer validates generalizability.

This paper introduces a network for volumetric segmentation that learns from sparsely annotated volumetric images. We outline two attractive use cases of this method: (1) In a semi-automated setup, the user annotates some slices in the volume to be segmented. The network learns from these sparse annotations and provides a dense 3D segmentation. (2) In a fully-automated setup, we assume that a representative, sparsely annotated training set exists. Trained on this data set, the network densely segments new volumetric images. The proposed network extends the previous u-net architecture from Ronneberger et al. by replacing all 2D operations with their 3D counterparts. The implementation performs on-the-fly elastic deformations for efficient data augmentation during training. It is trained end-to-end from scratch, i.e., no pre-trained network is required. We test the performance of the proposed method on a complex, highly variable 3D structure, the Xenopus kidney, and achieve good results for both use cases.

Segmentation of surgical instruments is crucial for enhancing surgeon performance and ensuring patient safety. Conventional techniques such as binary, semantic, and instance segmentation share a common drawback: they do not accommodate the parts of instruments obscured by tissues or other instruments. Precisely predicting the full extent of these occluded instruments can significantly improve laparoscopic surgeries by providing critical guidance during operations and assisting in the analysis of potential surgical errors, as well as serving educational purposes. In this paper, we introduce Amodal Segmentation to the realm of surgical instruments in the medical field. This technique identifies both the visible and occluded parts of an object. To achieve this, we introduce a new Amoal Instruments Segmentation (AIS) dataset, which was developed by reannotating each instrument with its complete mask, utilizing the 2017 MICCAI EndoVis Robotic Instrument Segmentation Challenge dataset. Additionally, we evaluate several leading amodal segmentation methods to establish a benchmark for this new dataset.

Over the past decade, computer vision applications in minimally invasive surgery have rapidly increased. Despite this growth, the impact of surgical computer vision remains limited compared to other medical fields like pathology and radiology, primarily due to the scarcity of representative annotated data. Whereas transfer learning from large annotated datasets such as ImageNet has been conventionally the norm to achieve high-performing models, recent advancements in self-supervised learning (SSL) have demonstrated superior performance. In medical image analysis, in-domain SSL pretraining has already been shown to outperform ImageNet-based initialization. Although unlabeled data in the field of surgical computer vision is abundant, the diversity within this data is limited. This study investigates the role of dataset diversity in SSL for surgical computer vision, comparing procedure-specific datasets against a more heterogeneous general surgical dataset across three different downstream surgical applications. The obtained results show that using solely procedure-specific data can lead to substantial improvements of 13.8%, 9.5%, and 36.8% compared to ImageNet pretraining. However, extending this data with more heterogeneous surgical data further increases performance by an additional 5.0%, 5.2%, and 2.5%, suggesting that increasing diversity within SSL data is beneficial for model performance. The code and pretrained model weights are made publicly available at https://github.com/TimJaspers0801/SurgeNet.

Intraoperative Cone Beam Computed Tomography (CBCT) provides a reliable 3D anatomical context essential for interventional planning. However, its static nature fails to provide continuous monitoring of soft-tissue deformations induced by respiration, probe pressure, and surgical manipulation, leading to navigation discrepancies. We propose a deformation-aware CBCT updating framework that leverages robotic ultrasound as a dynamic proxy to infer tissue motion and update static CBCT slices in real time. Starting from calibration-initialized alignment with linear correlation of linear combination (LC2)-based rigid refinement, our method establishes accurate multimodal correspondence. To capture intraoperative dynamics, we introduce the ultrasound correlation UNet (USCorUNet), a lightweight network trained with optical flow-guided supervision to learn deformation-aware correlation representations, enabling accurate, real-time dense deformation field estimation from ultrasound streams. The inferred deformation is spatially regularized and transferred to the CBCT reference to produce deformation-consistent visualizations without repeated radiation exposure. We validate the proposed approach through deformation estimation and ultrasound-guided CBCT updating experiments. Results demonstrate real-time end-to-end CBCT slice updating and physically plausible deformation estimation, enabling dynamic refinement of static CBCT guidance during robotic ultrasound-assisted interventions. The source code is publicly available at https://github.com/anonymous-codebase/us-cbct-demo.

Pruning neural networks, which involves removing a fraction of their weights, can often maintain high accuracy while significantly reducing model complexity, at least up to a certain limit. We present a neural network pruning technique that builds upon the Combinatorial Brain Surgeon, but solves an optimization problem over a subset of the network weights in an iterative, block-wise manner using block coordinate descent. The iterative, block-based nature of this pruning technique, which we dub ``iterative Combinatorial Brain Surgeon'' (iCBS) allows for scalability to very large models, including large language models (LLMs), that may not be feasible with a one-shot combinatorial optimization approach. When applied to large models like Mistral and DeiT, iCBS achieves higher performance metrics at the same density levels compared to existing pruning methods such as Wanda. This demonstrates the effectiveness of this iterative, block-wise pruning method in compressing and optimizing the performance of large deep learning models, even while optimizing over only a small fraction of the weights. Moreover, our approach allows for a quality-time (or cost) tradeoff that is not available when using a one-shot pruning technique alone. The block-wise formulation of the optimization problem enables the use of hardware accelerators, potentially offsetting the increased computational costs compared to one-shot pruning methods like Wanda. In particular, the optimization problem solved for each block is quantum-amenable in that it could, in principle, be solved by a quantum computer.

Constructing an adaptive hexahedral tessellation to fit an input triangle boundary is a key challenge in grid-based methods. The conventional method first removes outside elements (RO) and then projects the axis-aligned boundary onto the input triangle boundary, which has no guarantee on improving the initial Intersection over Union (IoU) and Hausdorff distance ratio (HR, w.r.t bounding box diagonal). The proposed MCHex approach replaces RO with a Marching Cubes method MCHex. Given the same computational budget (benchmarked using an identical precomputed Signed Distance Field, which dominates the runtime), MCHex provides better boundary approximation (higher IoU and lower HR) while guaranteeing a lower, yet still positive, minimum scaled Jacobian (>0 vs. RO's >0.48).

Robotic surgical systems rely heavily on high-quality visual feedback for precise teleoperation; yet, surgical smoke from energy-based devices significantly degrades endoscopic video feeds, compromising the human-robot interface and surgical outcomes. This paper presents RGA-Net (Reciprocal Gating and Attention-fusion Network), a novel deep learning framework specifically designed for smoke removal in robotic surgery workflows. Our approach addresses the unique challenges of surgical smoke-including dense, non-homogeneous distribution and complex light scattering-through a hierarchical encoder-decoder architecture featuring two key innovations: (1) a Dual-Stream Hybrid Attention (DHA) module that combines shifted window attention with frequency-domain processing to capture both local surgical details and global illumination changes, and (2) an Axis-Decomposed Attention (ADA) module that efficiently processes multi-scale features through factorized attention mechanisms. These components are connected via reciprocal cross-gating blocks that enable bidirectional feature modulation between encoder and decoder pathways. Extensive experiments on the DesmokeData and LSD3K surgical datasets demonstrate that RGA-Net achieves superior performance in restoring visual clarity suitable for robotic surgery integration. Our method enhances the surgeon-robot interface by providing consistently clear visualization, laying a technical foundation for alleviating surgeons' cognitive burden, optimizing operation workflows, and reducing iatrogenic injury risks in minimally invasive procedures. These practical benefits could be further validated through future clinical trials involving surgeon usability assessments. The proposed framework represents a significant step toward more reliable and safer robotic surgical systems through computational vision enhancement.

Endoscopic Submucosal Dissection (ESD) is a minimally invasive procedure initially developed for early gastric cancer treatment and has expanded to address diverse gastrointestinal lesions. While computer-assisted surgery (CAS) systems enhance ESD precision and safety, their efficacy hinges on accurate real-time surgical phase recognition, a task complicated by ESD's inherent complexity, including heterogeneous lesion characteristics and dynamic tissue interactions. Existing video-based phase recognition algorithms, constrained by inefficient temporal context modeling, exhibit limited performance in capturing fine-grained phase transitions and long-range dependencies. To overcome these limitations, we propose SPRMamba, a novel framework integrating a Mamba-based architecture with a Scaled Residual TranMamba (SRTM) block to synergize long-term temporal modeling and localized detail extraction. SPRMamba further introduces the Hierarchical Sampling Strategy to optimize computational efficiency, enabling real-time processing critical for clinical deployment. Evaluated on the ESD385 dataset and the cholecystectomy benchmark Cholec80, SPRMamba achieves state-of-the-art performance (87.64% accuracy on ESD385, +1.0% over prior methods), demonstrating robust generalizability across surgical workflows. This advancement bridges the gap between computational efficiency and temporal sensitivity, offering a transformative tool for intraoperative guidance and skill assessment in ESD surgery. The code is accessible at https://github.com/Zxnyyyyy/SPRMamba.

The skeleton of a digital image is a compact representation of its topology, geometry, and scale. It has utility in many computer vision applications, such as image description, segmentation, and registration. However, skeletonization has only seen limited use in contemporary deep learning solutions. Most existing skeletonization algorithms are not differentiable, making it impossible to integrate them with gradient-based optimization. Compatible algorithms based on morphological operations and neural networks have been proposed, but their results often deviate from the geometry and topology of the true medial axis. This work introduces the first three-dimensional skeletonization algorithm that is both compatible with gradient-based optimization and preserves an object's topology. Our method is exclusively based on matrix additions and multiplications, convolutional operations, basic non-linear functions, and sampling from a uniform probability distribution, allowing it to be easily implemented in any major deep learning library. In benchmarking experiments, we prove the advantages of our skeletonization algorithm compared to non-differentiable, morphological, and neural-network-based baselines. Finally, we demonstrate the utility of our algorithm by integrating it with two medical image processing applications that use gradient-based optimization: deep-learning-based blood vessel segmentation, and multimodal registration of the mandible in computed tomography and magnetic resonance images.

Advancements in computer-assisted surgical procedures heavily rely on accurate visual data interpretation from camera systems used during surgeries. Traditional open-access datasets focusing on surgical procedures are often limited by their small size, typically consisting of fewer than 100 videos with less than 100K images. To address these constraints, a new dataset called Surg-3M has been compiled using a novel aggregation pipeline that collects high-resolution videos from online sources. Featuring an extensive collection of over 4K surgical videos and more than 3 million high-quality images from multiple procedure types, Surg-3M offers a comprehensive resource surpassing existing alternatives in size and scope, including two novel tasks. To demonstrate the effectiveness of this dataset, we present SurgFM, a self-supervised foundation model pretrained on Surg-3M that achieves impressive results in downstream tasks such as surgical phase recognition, action recognition, and tool presence detection. Combining key components from ConvNeXt, DINO, and an innovative augmented distillation method, SurgFM exhibits exceptional performance compared to specialist architectures across various benchmarks. Our experimental results show that SurgFM outperforms state-of-the-art models in multiple downstream tasks, including significant gains in surgical phase recognition (+8.9pp, +4.7pp, and +3.9pp of Jaccard in AutoLaparo, M2CAI16, and Cholec80), action recognition (+3.1pp of mAP in CholecT50) and tool presence detection (+4.6pp of mAP in Cholec80). Moreover, even when using only half of the data, SurgFM outperforms state-of-the-art models in AutoLaparo and achieves state-of-the-art performance in Cholec80. Both Surg-3M and SurgFM have significant potential to accelerate progress towards developing autonomous robotic surgery systems.

Recent Artificial Intelligence (AI) models have matched or exceeded human experts in several benchmarks of biomedical task performance, but have lagged behind on surgical image-analysis benchmarks. Since surgery requires integrating disparate tasks -- including multimodal data integration, human interaction, and physical effects -- generally-capable AI models could be particularly attractive as a collaborative tool if performance could be improved. On the one hand, the canonical approach of scaling architecture size and training data is attractive, especially since there are millions of hours of surgical video data generated per year. On the other hand, preparing surgical data for AI training requires significantly higher levels of professional expertise, and training on that data requires expensive computational resources. These trade-offs paint an uncertain picture of whether and to-what-extent modern AI could aid surgical practice. In this paper, we explore this question through a case study of surgical tool detection using state-of-the-art AI methods available in 2026. We demonstrate that even with multi-billion parameter models and extensive training, current Vision Language Models fall short in the seemingly simple task of tool detection in neurosurgery. Additionally, we show scaling experiments indicating that increasing model size and training time only leads to diminishing improvements in relevant performance metrics. Thus, our experiments suggest that current models could still face significant obstacles in surgical use cases. Moreover, some obstacles cannot be simply ``scaled away'' with additional compute and persist across diverse model architectures, raising the question of whether data and label availability are the only limiting factors. We discuss the main contributors to these constraints and advance potential solutions.

Computer-assisted minimally invasive surgery has great potential in benefiting modern operating theatres. The video data streamed from the endoscope provides rich information to support context-awareness for next-generation intelligent surgical systems. To achieve accurate perception and automatic manipulation during the procedure, learning based technique is a promising way, which enables advanced image analysis and scene understanding in recent years. However, learning such models highly relies on large-scale, high-quality, and multi-task labelled data. This is currently a bottleneck for the topic, as available public dataset is still extremely limited in the field of CAI. In this paper, we present and release the first integrated dataset (named AutoLaparo) with multiple image-based perception tasks to facilitate learning-based automation in hysterectomy surgery. Our AutoLaparo dataset is developed based on full-length videos of entire hysterectomy procedures. Specifically, three different yet highly correlated tasks are formulated in the dataset, including surgical workflow recognition, laparoscope motion prediction, and instrument and key anatomy segmentation. In addition, we provide experimental results with state-of-the-art models as reference benchmarks for further model developments and evaluations on this dataset. The dataset is available at https://autolaparo.github.io.

Purpose: Accurate 3D hand pose estimation supports surgical applications such as skill assessment, robot-assisted interventions, and geometry-aware workflow analysis. However, surgical environments pose severe challenges, including intense and localized lighting, frequent occlusions by instruments or staff, and uniform hand appearance due to gloves, combined with a scarcity of annotated datasets for reliable model training. Method: We propose a robust multi-view pipeline for 3D hand pose estimation in surgical contexts that requires no domain-specific fine-tuning and relies solely on off-the-shelf pretrained models. The pipeline integrates reliable person detection, whole-body pose estimation, and state-of-the-art 2D hand keypoint prediction on tracked hand crops, followed by a constrained 3D optimization. In addition, we introduce a novel surgical benchmark dataset comprising over 68,000 frames and 3,000 manually annotated 2D hand poses with triangulated 3D ground truth, recorded in a replica operating room under varying levels of scene complexity. Results: Quantitative experiments demonstrate that our method consistently outperforms baselines, achieving a 31% reduction in 2D mean joint error and a 76% reduction in 3D mean per-joint position error. Conclusion: Our work establishes a strong baseline for 3D hand pose estimation in surgery, providing both a training-free pipeline and a comprehensive annotated dataset to facilitate future research in surgical computer vision.

Sphere packing, Hilbert's eighteenth problem, asks for the densest arrangement of congruent spheres in n-dimensional Euclidean space. Although relevant to areas such as cryptography, crystallography, and medical imaging, the problem remains unresolved: beyond a few special dimensions, neither optimal packings nor tight upper bounds are known. Even a major breakthrough in dimension n=8, later recognised with a Fields Medal, underscores its difficulty. A leading technique for upper bounds, the three-point method, reduces the problem to solving large, high-precision semidefinite programs (SDPs). Because each candidate SDP may take days to evaluate, standard data-intensive AI approaches are infeasible. We address this challenge by formulating SDP construction as a sequential decision process, the SDP game, in which a policy assembles SDP formulations from a set of admissible components. Using a sample-efficient model-based framework that combines Bayesian optimisation with Monte Carlo Tree Search, we obtain new state-of-the-art upper bounds in dimensions 4-16, showing that model-based search can advance computational progress in longstanding geometric problems. Together, these results demonstrate that sample-efficient, model-based search can make tangible progress on mathematically rigid, evaluation limited problems, pointing towards a complementary direction for AI-assisted discovery beyond large-scale LLM-driven exploration.

Crystalline materials are a fundamental component in next-generation technologies, yet modeling their distribution presents unique computational challenges. Of the plausible arrangements of atoms in a periodic lattice only a vanishingly small percentage are thermodynamically stable, which is a key indicator of the materials that can be experimentally realized. Two fundamental tasks in this area are to (a) predict the stable crystal structure of a known composition of elements and (b) propose novel compositions along with their stable structures. We present FlowMM, a pair of generative models that achieve state-of-the-art performance on both tasks while being more efficient and more flexible than competing methods. We generalize Riemannian Flow Matching to suit the symmetries inherent to crystals: translation, rotation, permutation, and periodic boundary conditions. Our framework enables the freedom to choose the flow base distributions, drastically simplifying the problem of learning crystal structures compared with diffusion models. In addition to standard benchmarks, we validate FlowMM's generated structures with quantum chemistry calculations, demonstrating that it is about 3x more efficient, in terms of integration steps, at finding stable materials compared to previous open methods.

We present an extension of the publicly available Spinal-Multiple-Myeloma-SEG dataset, a dual-energy CT imaging resource for multiple myeloma research. The purpose of this dataset is to enable voxel-wise analysis of vertebral bone microstructure by adding expert-validated segmentation of the trabecular compartment of lumbar vertebrae. The dataset consists of 72 dual-energy CT examinations from 67 adult patients (mean age 66 years, range 48--85; 36\% female), acquired retrospectively using a dual-layer dual-energy CT system. It includes conventional CT, virtual monoenergetic images, and calcium-suppressed reconstructions, along with structured clinical metadata. The data are provided in DICOM format, while segmentation masks are available in both NIfTI and DICOM-SEG formats. The primary intended applications include trabecular bone segmentation, quantitative bone mineral density-related analysis, and development of deep learning models for vertebral anatomy and disease-affected bone structures in multiple myeloma. The dataset supports both segmentation and multimodal learning tasks in pathological and non-pathological bone. Initial trabecular segmentation masks were generated using a pretrained nnU-Net model and subsequently refined through manual expert correction and radiological quality control, ensuring anatomical consistency. The original dataset is publicly available via TCIA (https://doi.org/10.7937/k4qv-hh78{https://doi.org/10.7937/k4qv-hh78}), while the trabecular segmentation extension (Version 2) is released through Zenodo (https://doi.org/10.5281/zenodo.21628232{https://doi.org/10.5281/zenodo.21628232}) under the CC BY 4.0 license. The Zenodo release provides immediate public access to the segmentation masks and will be additionally incorporated into the official TCIA collection after completion of the curation process.

Data scarcity remains a fundamental barrier to achieving fully autonomous surgical robots. While large scale vision language action (VLA) models have shown impressive generalization in household and industrial manipulation by leveraging paired video action data from diverse domains, surgical robotics suffers from the paucity of datasets that include both visual observations and accurate robot kinematics. In contrast, vast corpora of surgical videos exist, but they lack corresponding action labels, preventing direct application of imitation learning or VLA training. In this work, we aim to alleviate this problem by learning policy models from SurgWorld, a world model designed for surgical physical AI. We curated the Surgical Action Text Alignment (SATA) dataset with detailed action description specifically for surgical robots. Then we built SurgeWorld based on the most advanced physical AI world model and SATA. It's able to generate diverse, generalizable and realistic surgery videos. We are also the first to use an inverse dynamics model to infer pseudokinematics from synthetic surgical videos, producing synthetic paired video action data. We demonstrate that a surgical VLA policy trained with these augmented data significantly outperforms models trained only on real demonstrations on a real surgical robot platform. Our approach offers a scalable path toward autonomous surgical skill acquisition by leveraging the abundance of unlabeled surgical video and generative world modeling, thus opening the door to generalizable and data efficient surgical robot policies.

The surgical usage of Mixed Reality (MR) has received growing attention in areas such as surgical navigation systems, skill assessment, and robot-assisted surgeries. For such applications, pose estimation for hand and surgical instruments from an egocentric perspective is a fundamental task and has been studied extensively in the computer vision field in recent years. However, the development of this field has been impeded by a lack of datasets, especially in the surgical field, where bloody gloves and reflective metallic tools make it hard to obtain 3D pose annotations for hands and objects using conventional methods. To address this issue, we propose POV-Surgery, a large-scale, synthetic, egocentric dataset focusing on pose estimation for hands with different surgical gloves and three orthopedic surgical instruments, namely scalpel, friem, and diskplacer. Our dataset consists of 53 sequences and 88,329 frames, featuring high-resolution RGB-D video streams with activity annotations, accurate 3D and 2D annotations for hand-object pose, and 2D hand-object segmentation masks. We fine-tune the current SOTA methods on POV-Surgery and further show the generalizability when applying to real-life cases with surgical gloves and tools by extensive evaluations. The code and the dataset are publicly available at batfacewayne.github.io/POV_Surgery_io/.

Surgical resection remains the only potentially curative treatment for pancreatic ductal adenocarcinoma (PDAC), and eligibility depends on accurate assessment of vascular invasion (VI), i.e., tumor extension into adjacent critical vessels. Despite its importance for preoperative staging and surgical planning, computational VI assessment remains underexplored. Two major challenges are the lack of public datasets and the diagnostic ambiguity at the tumor-vessel interface, which leads to substantial inter-rater variability even among expert radiologists. To address these limitations, we introduce the CURVAS-PDACVI Dataset and Challenge, an open benchmark for uncertainty-aware AI in PDAC staging based on a densely annotated dataset with five independent expert annotations per scan. We also propose a multi-metric evaluation framework that extends beyond spatial overlap to include probabilistic calibration and VI assessment. Evaluation of six state-of-the-art methods shows that strong global volumetric overlap does not necessarily translate into reliable performance at clinically critical tumor-vessel interfaces. In particular, methods optimized for binary segmentation perform competitively on average overlap metrics, but often degrade in high-complexity cases with low expert consensus, either collapsing in volume or overextending at uncertain boundaries. In contrast, methods that model inter-rater disagreement produce better calibrated probabilistic maps and show greater robustness in these ambiguous cases. The benchmark highlights the limitations of volumetric accuracy as a proxy for localized surgical utility, motivating uncertainty-aware probabilistic models for preoperative decision-making.

With the advent of portable 360{\deg} cameras, panorama has gained significant attention in applications like virtual reality (VR), virtual tours, robotics, and autonomous driving. As a result, wide-baseline panorama view synthesis has emerged as a vital task, where high resolution, fast inference, and memory efficiency are essential. Nevertheless, existing methods are typically constrained to lower resolutions (512 times 1024) due to demanding memory and computational requirements. In this paper, we present PanSplat, a generalizable, feed-forward approach that efficiently supports resolution up to 4K (2048 times 4096). Our approach features a tailored spherical 3D Gaussian pyramid with a Fibonacci lattice arrangement, enhancing image quality while reducing information redundancy. To accommodate the demands of high resolution, we propose a pipeline that integrates a hierarchical spherical cost volume and Gaussian heads with local operations, enabling two-step deferred backpropagation for memory-efficient training on a single A100 GPU. Experiments demonstrate that PanSplat achieves state-of-the-art results with superior efficiency and image quality across both synthetic and real-world datasets. Code will be available at https://github.com/chengzhag/PanSplat.

Surgical video segmentation is a critical task in computer-assisted surgery and is vital for enhancing surgical quality and patient outcomes. Recently, the Segment Anything Model 2 (SAM2) framework has shown superior advancements in image and video segmentation. However, SAM2 struggles with efficiency due to the high computational demands of processing high-resolution images and complex and long-range temporal dynamics in surgical videos. To address these challenges, we introduce Surgical SAM 2 (SurgSAM-2), an advanced model to utilize SAM2 with an Efficient Frame Pruning (EFP) mechanism, to facilitate real-time surgical video segmentation. The EFP mechanism dynamically manages the memory bank by selectively retaining only the most informative frames, reducing memory usage and computational cost while maintaining high segmentation accuracy. Our extensive experiments demonstrate that SurgSAM-2 significantly improves both efficiency and segmentation accuracy compared to the vanilla SAM2. Remarkably, SurgSAM-2 achieves a 3times FPS compared with SAM2, while also delivering state-of-the-art performance after fine-tuning with lower-resolution data. These advancements establish SurgSAM-2 as a leading model for surgical video analysis, making real-time surgical video segmentation in resource-constrained environments a feasible reality.

We study the set of networks, which consist of sources, sinks and neutral points, bijective to the permutations. The set of directed edges, which characterizes a network, is constructed from a polyomino or a Rothe diagram of a permutation through a Dyck tiling on a ribbon. We introduce a new combinatorial object similar to a tree-like tableau, which we call a forest. A forest is shown to give a permutation, and be bijective to a network corresponding to the inverse of the permutation. We show that the poset of networks is a finite graded lattice and admits an EL-labeling. By use of this EL-labeling, we show the lattice is supersolvable and compute the M\"obius function of an interval of the poset.

In this paper, we study the ideas of composition and decomposition in the context of vector spaces, graphs and matroids. For vector spaces V_{AB}, treated as collection of row vectors, with specified column set Auplus B, we define V_{SP}lrarv V_{PQ}, Scap Q= emptyset, to be the collection of all vectors (f_S,f_Q) such that (f_S,f_P)in V_{SP}, (f_P,f_Q)in V_{PQ}. An analogous operation G_{SP}lrarg G_{PQ}equivd G_{PQ} can be defined in relation to graphs G_{SP}, G_{PQ}, on edge sets Suplus P, Puplus Q, respectively in terms of an overlapping subgraph G_P which gets deleted in the right side graph (see for instance the notion of k-sum oxley). For matroids we define the `linking' M_{SP}lrarm M_{PQ} equivd (M_{SP}vee M_{PQ})times (Suplus Q), denoting the contraction operation by 'times'. In each case, we examine how to minimize the size of the `overlap' set P, without affecting the right side entity. In the case of vector spaces, there is a polynomial time algorithm for achieving the minimum, which we present. Similar ideas work for graphs and for matroids under appropriate conditions. Next we consider the problem of decomposition. Here, in the case of vector spaces, the problem is to decompose V_{SQ} as V_{SP}lrarv V_{PQ}, with minimum size P. We give a polynomial time algorithm for this purpose. In the case of graphs and matroids we give a solution to this problem under certain restrictions.

Crystals are the foundation of numerous scientific and industrial applications. While various learning-based approaches have been proposed for crystal generation, existing methods seldom consider the space group constraint which is crucial in describing the geometry of crystals and closely relevant to many desirable properties. However, considering space group constraint is challenging owing to its diverse and nontrivial forms. In this paper, we reduce the space group constraint into an equivalent formulation that is more tractable to be handcrafted into the generation process. In particular, we translate the space group constraint into two parts: the basis constraint of the invariant logarithmic space of the lattice matrix and the Wyckoff position constraint of the fractional coordinates. Upon the derived constraints, we then propose DiffCSP++, a novel diffusion model that has enhanced a previous work DiffCSP by further taking space group constraint into account. Experiments on several popular datasets verify the benefit of the involvement of the space group constraint, and show that our DiffCSP++ achieves promising performance on crystal structure prediction, ab initio crystal generation and controllable generation with customized space groups.

Surgical scene understanding is critical for surgical training and robotic decision-making in robot-assisted surgery. Recent advances in Multimodal Large Language Models (MLLMs) have demonstrated great potential for advancing scene perception in the medical domain, facilitating surgeons to understand surgical scenes and procedures. However, these methods are primarily oriented towards image-based analysis or global video understanding, overlooking the fine-grained video reasoning that is crucial for analyzing specific processes and capturing detailed task execution within a surgical procedure. To bridge this gap, we propose SurgVidLM, the first video language model designed to address both full and fine-grained surgical video comprehension. To train our SurgVidLM, we construct the SVU-31K that is a large-scale dataset with over 31K video-instruction pairs, enabling both holistic understanding and detailed analysis of surgical procedures. Building on this resource, SurgVidLM incorporates a two-stage StageFocus mechanism: the first stage extracts global procedural context, while the second stage performs high-frequency local analysis guided by temporal cues. We also develop the Multi-frequency Fusion Attention to effectively integrate low- and high-frequency visual tokens, ensuring the preservation of critical task-specific details. Experimental results demonstrate that SurgVidLM significantly outperforms state-of-the-art Vid-LLMs of comparable parameter scale in both full and fine-grained video understanding tasks, showcasing its superior capability in capturing the context of complex robot-assisted surgeries. Our code and dataset will be publicly accessible soon.

Purpose: A profound education of novice surgeons is crucial to ensure that surgical interventions are effective and safe. One important aspect is the teaching of technical skills for minimally invasive or robot-assisted procedures. This includes the objective and preferably automatic assessment of surgical skill. Recent studies presented good results for automatic, objective skill evaluation by collecting and analyzing motion data such as trajectories of surgical instruments. However, obtaining the motion data generally requires additional equipment for instrument tracking or the availability of a robotic surgery system to capture kinematic data. In contrast, we investigate a method for automatic, objective skill assessment that requires video data only. This has the advantage that video can be collected effortlessly during minimally invasive and robot-assisted training scenarios. Methods: Our method builds on recent advances in deep learning-based video classification. Specifically, we propose to use an inflated 3D ConvNet to classify snippets, i.e., stacks of a few consecutive frames, extracted from surgical video. The network is extended into a Temporal Segment Network during training. Results: We evaluate the method on the publicly available JIGSAWS dataset, which consists of recordings of basic robot-assisted surgery tasks performed on a dry lab bench-top model. Our approach achieves high skill classification accuracies ranging from 95.1% to 100.0%. Conclusions: Our results demonstrate the feasibility of deep learning-based assessment of technical skill from surgical video. Notably, the 3D ConvNet is able to learn meaningful patterns directly from the data, alleviating the need for manual feature engineering. Further evaluation will require more annotated data for training and testing.

In his celebrated book "Mathematical Treatise in Nine Sections" of 1247, Qin, Jiushao described the Chinese remainder theorem with great detail and generality. He also gave a method for computing modular inverse under the name of "DaYan deriving one". Historical significance of DaYan deriving one method has been well studied. In this paper, we investigate its modern mathematical nature from the perspectives of number theory and algorithm. One of the remarkable features of Qin's algorithm is that it keeps a state of four variables in a matrix form. Its choice of variables and layout provide natural ways of connecting several important mathematical concepts. An invariant about the state is also observed which provides a convenient yet powerful tool in proving several important mathematical results. The paper first explains Qin's algorithm and proves some of its properties. Then the connection with continued fractions is examined, the results show that the states of Qin's algorithm contain rich information about continued fractions and some classical arguments can be derived easily. The last part of the paper discusses a family of 2-dimensional lattices of number theoretic significance by proving that the shortest vectors of these lattices can be obtained from the states of Qin's algorithm. This result is surprising in that a shortest lattice vector is found in a well-regulated set. A method of computing such shortest vectors is proposed.ed.

PURPOSE: Surgical workflow and skill analysis are key technologies for the next generation of cognitive surgical assistance systems. These systems could increase the safety of the operation through context-sensitive warnings and semi-autonomous robotic assistance or improve training of surgeons via data-driven feedback. In surgical workflow analysis up to 91% average precision has been reported for phase recognition on an open data single-center dataset. In this work we investigated the generalizability of phase recognition algorithms in a multi-center setting including more difficult recognition tasks such as surgical action and surgical skill. METHODS: To achieve this goal, a dataset with 33 laparoscopic cholecystectomy videos from three surgical centers with a total operation time of 22 hours was created. Labels included annotation of seven surgical phases with 250 phase transitions, 5514 occurences of four surgical actions, 6980 occurences of 21 surgical instruments from seven instrument categories and 495 skill classifications in five skill dimensions. The dataset was used in the 2019 Endoscopic Vision challenge, sub-challenge for surgical workflow and skill analysis. Here, 12 teams submitted their machine learning algorithms for recognition of phase, action, instrument and/or skill assessment. RESULTS: F1-scores were achieved for phase recognition between 23.9% and 67.7% (n=9 teams), for instrument presence detection between 38.5% and 63.8% (n=8 teams), but for action recognition only between 21.8% and 23.3% (n=5 teams). The average absolute error for skill assessment was 0.78 (n=1 team). CONCLUSION: Surgical workflow and skill analysis are promising technologies to support the surgical team, but are not solved yet, as shown by our comparison of algorithms. This novel benchmark can be used for comparable evaluation and validation of future work.

Vision foundation models (VFMs) have emerged as powerful tools for surgical scene understanding. However, current approaches predominantly rely on unimodal RGB pre-training, overlooking the complex 3D geometry inherent to surgical environments. Although several architectures support multimodal or geometry-aware inputs in general computer vision, the benefits of incorporating depth information in surgical settings remain underexplored. We conduct a large-scale empirical study comparing eight ViT-based VFMs that differ in pre-training domain, learning objective, and input modality (RGB vs. RGB-D). For pre-training, we use a curated dataset of 1.4 million robotic surgical images paired with depth maps generated from an off-the-shelf network. We evaluate these models under both frozen-backbone and end-to-end fine-tuning protocols across eight surgical datasets spanning object detection, segmentation, depth estimation, and pose estimation. Our experiments yield several consistent findings. Models incorporating explicit geometric tokenization, such as MultiMAE, substantially outperform unimodal baselines across all tasks. Notably, geometric-aware pre-training enables remarkable data efficiency: models fine-tuned on just 25% of labeled data consistently surpass RGB-only models trained on the full dataset. Importantly, these gains require no architectural or runtime changes at inference; depth is used only during pre-training, making adoption straightforward. These findings suggest that multimodal pre-training offers a viable path towards building more capable surgical vision systems.

submucosal dissection (ESD) enables rapid resection of large lesions, minimizing recurrence rates and improving long-term overall survival. Despite these advantages, ESD is technically challenging and carries high risks of complications, necessitating skilled surgeons and precise instruments. Recent advancements in Large Visual-Language Models (LVLMs) offer promising decision support and predictive planning capabilities for robotic systems, which can augment the accuracy of ESD and reduce procedural risks. However, existing datasets for multi-level fine-grained ESD surgical motion understanding are scarce and lack detailed annotations. In this paper, we design a hierarchical decomposition of ESD motion granularity and introduce a multi-level surgical motion dataset (CoPESD) for training LVLMs as the robotic Co-Pilot of Endoscopic Submucosal Dissection. CoPESD includes 17,679 images with 32,699 bounding boxes and 88,395 multi-level motions, from over 35 hours of ESD videos for both robot-assisted and conventional surgeries. CoPESD enables granular analysis of ESD motions, focusing on the complex task of submucosal dissection. Extensive experiments on the LVLMs demonstrate the effectiveness of CoPESD in training LVLMs to predict following surgical robotic motions. As the first multimodal ESD motion dataset, CoPESD supports advanced research in ESD instruction-following and surgical automation. The dataset is available at https://github.com/gkw0010/CoPESD{https://github.com/gkw0010/CoPESD.}}

Real-time reconstruction of deformable surgical scenes is vital for advancing robotic surgery, improving intraoperative guidance, and enabling automation. Recent methods achieve dense reconstructions from da Vinci robotic surgery videos, with Gaussian Splatting (GS) offering real-time performance via graphics acceleration. However, reconstruction quality in occluded regions remains limited, and depth accuracy has not been fully assessed, as benchmarks like EndoNeRF and StereoMIS lack 3D ground truth. We propose Diff2DGS, a two-stage framework for reliable 3D reconstruction of occluded surgical scenes. First, a diffusion-based video module with temporal priors inpaints tissue occluded by instruments with high spatiotemporal consistency. Second, we adapt 2D Gaussian Splatting (2DGS) with a Learnable Deformation Model (LDM) to capture dynamic tissue deformation and anatomical geometry, and introduce adaptive depth weight to improve geometric fidelity. We further extend evaluation beyond image-quality metrics by performing quantitative depth analysis on the SCARED dataset. Diff2DGS outperforms state-of-the-art methods in both appearance and geometry, reaching 38.02 dB PSNR on EndoNeRF and 34.40 dB on StereoMIS. Our experiments also show that optimizing image quality alone does not necessarily ensure accurate 3D geometry.The code is available at https://diff2dgs.github.io/.

Precise spatial modeling in the operating room (OR) is foundational to many clinical tasks, supporting intraoperative awareness, hazard avoidance, and surgical decision-making. While existing approaches leverage large-scale multimodal datasets for latent-space alignment to implicitly learn spatial relationships, they overlook the 3D capabilities of MLLMs. However, this approach raises two issues: (1) Operating rooms typically lack multiple video and audio sensors, making multimodal 3D data difficult to obtain; (2) Training solely on readily available 2D data fails to capture fine-grained details in complex scenes. To address this gap, we introduce Spatial-ORMLLM, the first large vision-language model for 3D spatial reasoning in operating rooms using only RGB modality to infer volumetric and semantic cues, enabling downstream medical tasks with detailed and holistic spatial context. Spatial-ORMLLM incorporates a Spatial-Enhanced Feature Fusion Block, which integrates 2D modality inputs with rich 3D spatial knowledge extracted by the estimation algorithm and then feeds the combined features into the visual tower. By employing a unified end-to-end MLLM framework, it combines powerful spatial features with textual features to deliver robust 3D scene reasoning without any additional expert annotations or sensor inputs. Experiments on multiple benchmark clinical datasets demonstrate that Spatial-ORMLLM achieves state-of-the-art performance and generalizes robustly to previously unseen surgical scenarios and downstream tasks.

Reliable recognition and localization of surgical instruments in endoscopic video recordings are foundational for a wide range of applications in computer- and robot-assisted minimally invasive surgery (RAMIS), including surgical training, skill assessment, and autonomous assistance. However, robust performance under real-world conditions remains a significant challenge. Incorporating surgical context - such as the current procedural phase - has emerged as a promising strategy to improve robustness and interpretability. To address these challenges, we organized the Surgical Procedure Phase, Keypoint, and Instrument Recognition (PhaKIR) sub-challenge as part of the Endoscopic Vision (EndoVis) challenge at MICCAI 2024. We introduced a novel, multi-center dataset comprising thirteen full-length laparoscopic cholecystectomy videos collected from three distinct medical institutions, with unified annotations for three interrelated tasks: surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation. Unlike existing datasets, ours enables joint investigation of instrument localization and procedural context within the same data while supporting the integration of temporal information across entire procedures. We report results and findings in accordance with the BIAS guidelines for biomedical image analysis challenges. The PhaKIR sub-challenge advances the field by providing a unique benchmark for developing temporally aware, context-driven methods in RAMIS and offers a high-quality resource to support future research in surgical scene understanding.

Recent advancements in surgical computer vision have been driven by vision-only models, which lack language semantics, relying on manually annotated videos to predict fixed object categories. This limits their generalizability to unseen surgical procedures and tasks. We propose leveraging surgical video lectures from e-learning platforms to provide effective vision and language supervisory signals for multi-modal representation learning, bypassing manual annotations. We address surgery-specific linguistic challenges using multiple automatic speech recognition systems for text transcriptions. We introduce SurgVLP - Surgical Vision Language Pre-training - a novel method for multi-modal representation learning. SurgVLP employs a new contrastive learning objective, aligning video clip embeddings with corresponding multiple text embeddings in a joint latent space. We demonstrate the representational capability of this space through several vision-and-language surgical tasks and vision-only tasks specific to surgery. Unlike current fully supervised approaches, SurgVLP adapts to different surgical procedures and tasks without specific fine-tuning, achieving zero-shot adaptation to tasks such as surgical tool, phase, and triplet recognition without manual annotation. These results highlight the transferability and versatility of the learned multi-modal representations in surgical video analysis. The code is available at https://github.com/CAMMA-public/SurgVLP

Visual Question Answering (VQA) in robotic surgery, referred to as surgical VQA, requires high-level understanding of complex surgical scenes and the integration of visual perception with language reasoning, with the potential to support surgical training and intraoperative decision-making. Recent Vision-Language Models (VLMs) have shown promising performance through parameter-efficient fine-tuning; however, most existing approaches rely on coarse visual grounding, typically limited to bounding boxes, which fails to capture the fine-grained spatial structure of surgical objects. In this work, we propose a unified framework that jointly performs pixel-level segmentation and visual question answering within a single framework. Our approach integrates a VLM with a Segment Anything Model (SAM)-based decoder and represents scene elements as object tokens generated by the VLM. These object tokens guide answer prediction and are further projected to the SAM-based decoder to produce segmentation masks. By optimizing the object token embeddings through both segmentation and question answering objectives, the model learns spatially grounded representations that enhance visual reasoning while providing explicit pixel-level grounding. We evaluate the proposed method on the private RAMIE (Robot-Assisted Minimally Invasive Esophagectomy) dataset and the public EndoVis18 dataset, where it consistently outperforms baseline methods for surgical VQA. These results demonstrate that incorporating context-aware object tokens into vision-language models improves fine-grained surgical scene understanding.

Accurate recognition of anatomical structures is essential for safe and effective minimally invasive surgery (MIS), yet it remains underexplored in surgical computer vision due to limited annotated data and methods tailored primarily to natural scenes. In this work, we present a combined dataset and model framework to advance anatomy-aware perception in MIS. First, we introduce ATLAS-120k, a large-scale clip-level semantic segmentation dataset comprising over 120,000 annotated frames from 100 surgical videos spanning 14 procedures and multiple modalities, including laparoscopic and robot-assisted surgery. The dataset captures substantial procedural variability and was created using a scalable annotation pipeline that integrates expert manual labeling, automated propagation, iterative refinement, and surgeon verification to ensure high-quality annotations. Second, we propose ATLAS (Anatomy Recognition with Context Learning using Foundation Representations), a video semantic segmentation model specifically designed for surgical anatomy recognition. Unlike conventional approaches that emphasize object tracking, ATLAS leverages foundation-model embeddings together with lightweight temporal reasoning to incorporate contextual cues such as procedure type, surgical phase, and short-term visual memory. This design enables temporally consistent and accurate predictions while maintaining real-time feasibility. Together, the dataset and model establish a practical foundation for robust surgical scene understanding and support the development of clinically applicable guidance systems for minimally invasive surgery. The models, dataset annotations and annotation platform are publicly available at: https://github.com/TimJaspers0801/ATLAS.

High-resolution imaging is crucial for enhancing visual clarity and enabling precise computer-assisted guidance in minimally invasive surgery (MIS). Despite the increasing adoption of 4K endoscopic systems, there remains a significant gap in publicly available native 4K datasets tailored specifically for robotic-assisted MIS. We introduce SurgiSR4K, the first publicly accessible surgical imaging and video dataset captured at a native 4K resolution, representing realistic conditions of robotic-assisted procedures. SurgiSR4K comprises diverse visual scenarios including specular reflections, tool occlusions, bleeding, and soft tissue deformations, meticulously designed to reflect common challenges faced during laparoscopic and robotic surgeries. This dataset opens up possibilities for a broad range of computer vision tasks that might benefit from high resolution data, such as super resolution (SR), smoke removal, surgical instrument detection, 3D tissue reconstruction, monocular depth estimation, instance segmentation, novel view synthesis, and vision-language model (VLM) development. SurgiSR4K provides a robust foundation for advancing research in high-resolution surgical imaging and fosters the development of intelligent imaging technologies aimed at enhancing performance, safety, and usability in image-guided robotic surgeries.

Integration of Vision-Language Models (VLMs) in surgical intelligence is hindered by hallucinations, domain knowledge gaps, and limited understanding of task interdependencies within surgical scenes, undermining clinical reliability. While recent VLMs demonstrate strong general reasoning and thinking capabilities, they still lack the domain expertise and task-awareness required for precise surgical scene interpretation. Although Chain-of-Thought (CoT) can structure reasoning more effectively, current approaches rely on self-generated CoT steps, which often exacerbate inherent domain gaps and hallucinations. To overcome this, we present SurgRAW, a CoT-driven multi-agent framework that delivers transparent, interpretable insights for most tasks in robotic-assisted surgery. By employing specialized CoT prompts across five tasks: instrument recognition, action recognition, action prediction, patient data extraction, and outcome assessment, SurgRAW mitigates hallucinations through structured, domain-aware reasoning. Retrieval-Augmented Generation (RAG) is also integrated to external medical knowledge to bridge domain gaps and improve response reliability. Most importantly, a hierarchical agentic system ensures that CoT-embedded VLM agents collaborate effectively while understanding task interdependencies, with a panel discussion mechanism promotes logical consistency. To evaluate our method, we introduce SurgCoTBench, the first reasoning-based dataset with structured frame-level annotations. With comprehensive experiments, we demonstrate the effectiveness of proposed SurgRAW with 29.32% accuracy improvement over baseline VLMs on 12 robotic procedures, achieving the state-of-the-art performance and advancing explainable, trustworthy, and autonomous surgical assistance.

Modeling medical vessel-like anatomy is challenging due to its intricate topology and sensitivity to dataset shifts. Consequently, task-specific models often suffer from topological inconsistencies, including artificial disconnections and spurious merges. Motivated by the promise of multimodal large language models (MLLMs) for zero-shot generalization, we propose TubeMLLM, a unified foundation model that couples structured understanding with controllable generation for medical vessel-like anatomy. By integrating topological priors through explicit natural language prompting and aligning them with visual representations in a shared-attention architecture, TubeMLLM significantly enhances topology-aware perception. Furthermore, we construct TubeMData, a pionner multimodal benchmark comprising comprehensive topology-centric tasks, and introduce an adaptive loss weighting strategy to emphasize topology-critical regions during training. Extensive experiments on fifteen diverse datasets demonstrate our superiority. Quantitatively, TubeMLLM achieves state-of-the-art out-of-distribution performance, substantially reducing global topological discrepancies on color fundus photography (decreasing the β_{0} number error from 37.42 to 8.58 compared to baselines). Notably, TubeMLLM exhibits exceptional zero-shot cross-modality transferring ability on unseen X-ray angiography, achieving a Dice score of 67.50% while significantly reducing the β_{0} error to 1.21. TubeMLLM also maintains robustness against degradations such as blur, noise, and low resolution. Furthermore, in topology-aware understanding tasks, the model achieves 97.38% accuracy in evaluating mask topological quality, significantly outperforming standard vision-language baselines.

Surgery video segmentation is an important topic in the surgical AI field. It allows the AI model to understand the spatial information of a surgical scene. Meanwhile, due to the lack of annotated surgical data, surgery segmentation models suffer from limited performance. With the emergence of SAM2 model, a large foundation model for video segmentation trained on natural videos, zero-shot surgical video segmentation became more realistic but meanwhile remains to be explored. In this paper, we systematically evaluate the performance of SAM2 model in zero-shot surgery video segmentation task. We conducted experiments under different configurations, including different prompting strategies, robustness, etc. Moreover, we conducted an empirical evaluation over the performance, including 9 datasets with 17 different types of surgeries.

We introduce a novel FSVOS model that employs a local matching strategy to restrict the search space to the most relevant neighboring pixels. Rather than relying on inefficient standard im2col-like implementations (e.g., spatial convolutions, depthwise convolutions and feature-shifting mechanisms) or hardware-specific CUDA kernels (e.g., deformable and neighborhood attention), which often suffer from limited portability across non-CUDA devices, we reorganize the local sampling process through a direction-based sampling perspective. Specifically, we implement a non-parametric sampling mechanism that enables dynamically varying sampling regions. This approach provides the flexibility to adapt to diverse spatial structures without the computational costs of parametric layers and the need for model retraining. To further enhance feature coherence across frames, we design a supervised spatio-temporal contrastive learning scheme that enforces consistency in feature representations. In addition, we introduce a publicly available benchmark dataset for multi-object segmentation in X-ray angiography videos (MOSXAV), featuring detailed, manually labeled segmentation ground truth. Extensive experiments on the CADICA, XACV, and MOSXAV datasets show that our proposed FSVOS method outperforms current state-of-the-art video segmentation methods in terms of segmentation accuracy and generalization capability (i.e., seen and unseen categories). This work offers enhanced flexibility and potential for a wide range of clinical applications.

Voronoi diagrams are essential geometrical structures with numerous applications, particularly astrophysics-driven finite volume methods. While serial algorithms for constructing these entities are well-established, parallel construction remains challenging. This is especially true in distributed memory systems, where each host manages only a subset of the input points. This process requires redistributing points across hosts and accurately computing the corresponding Voronoi cells. In this paper, we introduce a new distributed construction algorithm, which is implemented in our open-source C++ 3-dimensional Voronoi construction framework. Our approach leverages Delaunay triangulation as an intermediate step, which is then transformed into a Voronoi diagram. We introduce the algorithms we implemented for the precise construction and our load-balancing approach and compare the running time with other state-of-the-art frameworks. MadVoro is a versatile tool that can be applied in various scientific domains, such as mesh decomposition, computational physics, chemistry, and machine learning.

Gastrointestinal malignancies constitute a leading cause of cancer-related mortality worldwide, with advanced-stage prognosis remaining particularly dismal. Originating as a groundbreaking technique for early gastric cancer treatment, Endoscopic Submucosal Dissection has evolved into a versatile intervention for diverse gastrointestinal lesions. While computer-assisted systems significantly enhance procedural precision and safety in ESD, their clinical adoption faces a critical bottleneck: reliable surgical phase recognition within complex endoscopic workflows. Current state-of-the-art approaches predominantly rely on multi-stage refinement architectures that iteratively optimize temporal predictions. In this paper, we present Clinical Prior Knowledge-Constrained Diffusion (CPKD), a novel generative framework that reimagines phase recognition through denoising diffusion principles while preserving the core iterative refinement philosophy. This architecture progressively reconstructs phase sequences starting from random noise and conditioned on visual-temporal features. To better capture three domain-specific characteristics, including positional priors, boundary ambiguity, and relation dependency, we design a conditional masking strategy. Furthermore, we incorporate clinical prior knowledge into the model training to improve its ability to correct phase logical errors. Comprehensive evaluations on ESD820, Cholec80, and external multi-center demonstrate that our proposed CPKD achieves superior or comparable performance to state-of-the-art approaches, validating the effectiveness of diffusion-based generative paradigms for surgical phase recognition.

While deep learning and deep reinforcement learning (RL) systems have demonstrated impressive results in domains such as image classification, game playing, and robotic control, data efficiency remains a major challenge. Multi-task learning has emerged as a promising approach for sharing structure across multiple tasks to enable more efficient learning. However, the multi-task setting presents a number of optimization challenges, making it difficult to realize large efficiency gains compared to learning tasks independently. The reasons why multi-task learning is so challenging compared to single-task learning are not fully understood. In this work, we identify a set of three conditions of the multi-task optimization landscape that cause detrimental gradient interference, and develop a simple yet general approach for avoiding such interference between task gradients. We propose a form of gradient surgery that projects a task's gradient onto the normal plane of the gradient of any other task that has a conflicting gradient. On a series of challenging multi-task supervised and multi-task RL problems, this approach leads to substantial gains in efficiency and performance. Further, it is model-agnostic and can be combined with previously-proposed multi-task architectures for enhanced performance.

Self-supervised learning has enabled large-scale pre-training on 2D natural images, producing general-purpose visual representations that transfer effectively across tasks. However, many medical imaging modalities, such as CT scans, are inherently three-dimensional and differ fundamentally from natural images in both structure and semantics. Volumetric modalities capture spatial continuity, organ anatomy, and intensity-based tissue properties (e.g., Hounsfield Units), which are not adequately modeled by 2D pre-training. To bridge this gap, we introduce CoralBay, a self-distillation framework that extends DINO by using a hierarchical 3D Swin backbone and applying self-distillation to concatenated multi-scale features, enabling data-efficient self-supervised learning of rich spatial representations that encode both global semantics and fine-grained local structure. As a result, CoralBay transfers effectively to a wide range of downstream radiological tasks, demonstrating strong and consistent performance across diverse anatomical targets. In addition, we contribute to the open-source \eva framework by introducing a public, reproducible 3D radiology leaderboard that unifies multiple datasets and establishes a standardized benchmark for evaluating volumetric representation learning methods.

Understanding the workflow of surgical procedures in complex operating rooms requires a deep understanding of the interactions between clinicians and their environment. Surgical activity recognition (SAR) is a key computer vision task that detects activities or phases from multi-view camera recordings. Existing SAR models often fail to account for fine-grained clinician movements and multi-view knowledge, or they require calibrated multi-view camera setups and advanced point-cloud processing to obtain better results. In this work, we propose a novel calibration-free multi-view multi-modal pretraining framework called Multiview Pretraining for Video-Pose Surgical Activity Recognition PreViPS, which aligns 2D pose and vision embeddings across camera views. Our model follows CLIP-style dual-encoder architecture: one encoder processes visual features, while the other encodes human pose embeddings. To handle the continuous 2D human pose coordinates, we introduce a tokenized discrete representation to convert the continuous 2D pose coordinates into discrete pose embeddings, thereby enabling efficient integration within the dual-encoder framework. To bridge the gap between these two modalities, we propose several pretraining objectives using cross- and in-modality geometric constraints within the embedding space and incorporating masked pose token prediction strategy to enhance representation learning. Extensive experiments and ablation studies demonstrate improvements over the strong baselines, while data-efficiency experiments on two distinct operating room datasets further highlight the effectiveness of our approach. We highlight the benefits of our approach for surgical activity recognition in both multi-view and single-view settings, showcasing its practical applicability in complex surgical environments. Code will be made available at: https://github.com/CAMMA-public/PreViPS.

Data diversity and volume are crucial to the success of training deep learning models, while in the medical imaging field, the difficulty and cost of data collection and annotation are especially huge. Specifically in robotic surgery, data scarcity and imbalance have heavily affected the model accuracy and limited the design and deployment of deep learning-based surgical applications such as surgical instrument segmentation. Considering this, we rethink the surgical instrument segmentation task and propose a one-to-many data generation solution that gets rid of the complicated and expensive process of data collection and annotation from robotic surgery. In our method, we only utilize a single surgical background tissue image and a few open-source instrument images as the seed images and apply multiple augmentations and blending techniques to synthesize amounts of image variations. In addition, we also introduce the chained augmentation mixing during training to further enhance the data diversities. The proposed approach is evaluated on the real datasets of the EndoVis-2018 and EndoVis-2017 surgical scene segmentation. Our empirical analysis suggests that without the high cost of data collection and annotation, we can achieve decent surgical instrument segmentation performance. Moreover, we also observe that our method can deal with novel instrument prediction in the deployment domain. We hope our inspiring results will encourage researchers to emphasize data-centric methods to overcome demanding deep learning limitations besides data shortage, such as class imbalance, domain adaptation, and incremental learning. Our code is available at https://github.com/lofrienger/Single_SurgicalScene_For_Segmentation.

The integration of artificial intelligence in image-guided interventions holds transformative potential, promising to extract 3D geometric and quantitative information from conventional 2D imaging modalities during complex procedures. Achieving this requires the rapid and precise alignment of 2D intraoperative images (e.g., X-ray) with 3D preoperative volumes (e.g., CT, MRI). However, current 2D/3D registration methods fail across the broad spectrum of procedures dependent on X-ray guidance: traditional optimization techniques require custom parameter tuning for each subject, whereas neural networks trained on small datasets do not generalize to new patients or require labor-intensive manual annotations, increasing clinical burden and precluding application to new anatomical targets. To address these challenges, we present xvr, a fully automated framework for training patient-specific neural networks for 2D/3D registration. xvr uses physics-based simulation to generate abundant high-quality training data from a patient's own preoperative volumetric imaging, thereby overcoming the inherently limited ability of supervised models to generalize to new patients and procedures. Furthermore, xvr requires only 5 minutes of training per patient, making it suitable for emergency interventions as well as planned procedures. We perform the largest evaluation of a 2D/3D registration algorithm on real X-ray data to date and find that xvr robustly generalizes across a diverse dataset comprising multiple anatomical structures, imaging modalities, and hospitals. Across surgical tasks, xvr achieves submillimeter-accurate registration at intraoperative speeds, improving upon existing methods by an order of magnitude. xvr is released as open-source software freely available at https://github.com/eigenvivek/xvr.

In the medical domain, the lack of large training data sets and benchmarks is often a limiting factor for training deep neural networks. In contrast to expensive manual labeling, computer simulations can generate large and fully labeled data sets with a minimum of manual effort. However, models that are trained on simulated data usually do not translate well to real scenarios. To bridge the domain gap between simulated and real laparoscopic images, we exploit recent advances in unpaired image-to-image translation. We extent an image-to-image translation method to generate a diverse multitude of realistically looking synthetic images based on images from a simple laparoscopy simulation. By incorporating means to ensure that the image content is preserved during the translation process, we ensure that the labels given for the simulated images remain valid for their realistically looking translations. This way, we are able to generate a large, fully labeled synthetic data set of laparoscopic images with realistic appearance. We show that this data set can be used to train models for the task of liver segmentation of laparoscopic images. We achieve average dice scores of up to 0.89 in some patients without manually labeling a single laparoscopic image and show that using our synthetic data to pre-train models can greatly improve their performance. The synthetic data set will be made publicly available, fully labeled with segmentation maps, depth maps, normal maps, and positions of tools and camera (http://opencas.dkfz.de/image2image).

We perform a Monte Carlo analysis of the Ising model on many three-dimensional lattices. By means of finite-size scaling we obtain the critical points and determine the scaling dimensions. As expected, the critical exponents agree with the three-dimensional Ising universality class for all models. The irrelevant field, as revealed by the correction-to-scaling amplitudes, appears to be relatively large. Combining the Monte Carlo results for the hydrogen peroxide lattice with those for five other three-dimensional lattices, we obtain a set of data covering a wide range of the irrelevant temperature field. This is helpful in the determination of the parameters describing the corrections to scaling. As a consequence, new results are obtained for the universal parameters describing Ising criticality in three dimensions, with reduced error margins in comparison with earlier Monte Carlo analyses. The critical exponents describing the thermodynamic singularities are determined by the temperature renormalization exponent y_t = 1.58693 (9) and the magnetic renormalization exponent y_h = 2.48178 (5). The corrections to scaling are governed by the irrelevant exponent y_1 = -0.821 (5).

Most benchmarks for studying surgical interventions focus on a specific challenge instead of leveraging the intrinsic complementarity among different tasks. In this work, we present a new experimental framework towards holistic surgical scene understanding. First, we introduce the Phase, Step, Instrument, and Atomic Visual Action recognition (PSI-AVA) Dataset. PSI-AVA includes annotations for both long-term (Phase and Step recognition) and short-term reasoning (Instrument detection and novel Atomic Action recognition) in robot-assisted radical prostatectomy videos. Second, we present Transformers for Action, Phase, Instrument, and steps Recognition (TAPIR) as a strong baseline for surgical scene understanding. TAPIR leverages our dataset's multi-level annotations as it benefits from the learned representation on the instrument detection task to improve its classification capacity. Our experimental results in both PSI-AVA and other publicly available databases demonstrate the adequacy of our framework to spur future research on holistic surgical scene understanding.

Foundation models have revolutionized computer vision by achieving vastly superior performance across diverse tasks through large-scale pretraining on extensive datasets. However, their application in surgical computer vision has been limited. This study addresses this gap by introducing SurgeNetXL, a novel surgical foundation model that sets a new benchmark in surgical computer vision. Trained on the largest reported surgical dataset to date, comprising over 4.7 million video frames, SurgeNetXL achieves consistent top-tier performance across six datasets spanning four surgical procedures and three tasks, including semantic segmentation, phase recognition, and critical view of safety (CVS) classification. Compared with the best-performing surgical foundation models, SurgeNetXL shows mean improvements of 2.4, 9.0, and 12.6 percent for semantic segmentation, phase recognition, and CVS classification, respectively. Additionally, SurgeNetXL outperforms the best-performing ImageNet-based variants by 14.4, 4.0, and 1.6 percent in the respective tasks. In addition to advancing model performance, this study provides key insights into scaling pretraining datasets, extending training durations, and optimizing model architectures specifically for surgical computer vision. These findings pave the way for improved generalizability and robustness in data-scarce scenarios, offering a comprehensive framework for future research in this domain. All models and a subset of the SurgeNetXL dataset, including over 2 million video frames, are publicly available at: https://github.com/TimJaspers0801/SurgeNet.

We formalize a transfinite Phi process that treats all possibility embeddings as operators on structured state spaces including complete lattices, Banach and Hilbert spaces, and orthomodular lattices. We prove a determinization lemma showing that lifting to sets or distributions yields a deterministic global dynamic, an ordinal stabilization theorem sending operator transforms to the fixed subspace by stage omega under normal spectral contraction, and a product of Riesz projections theorem for commuting layers. We establish a compositionality law for lifted maps, show closure of Phi packings, and present a quantitative application to sensory depletion that models tissue removal as a projection and derives strict decreases in the attainable fixed point under minimal monotonicity and positivity assumptions. We also state measurable conditions for probabilistic lifts, give explicit non normal and non commuting counterexamples, and provide finite dimensional and stochastic witnesses together with per theorem scope tables and a small reproducible code appendix.

Surgical scene segmentation is critical in computer-assisted surgery and is vital for enhancing surgical quality and patient outcomes. Recently, referring surgical segmentation is emerging, given its advantage of providing surgeons with an interactive experience to segment the target object. However, existing methods are limited by low efficiency and short-term tracking, hindering their applicability in complex real-world surgical scenarios. In this paper, we introduce ReSurgSAM2, a two-stage surgical referring segmentation framework that leverages Segment Anything Model 2 to perform text-referred target detection, followed by tracking with reliable initial frame identification and diversity-driven long-term memory. For the detection stage, we propose a cross-modal spatial-temporal Mamba to generate precise detection and segmentation results. Based on these results, our credible initial frame selection strategy identifies the reliable frame for the subsequent tracking. Upon selecting the initial frame, our method transitions to the tracking stage, where it incorporates a diversity-driven memory mechanism that maintains a credible and diverse memory bank, ensuring consistent long-term tracking. Extensive experiments demonstrate that ReSurgSAM2 achieves substantial improvements in accuracy and efficiency compared to existing methods, operating in real-time at 61.2 FPS. Our code and datasets will be available at https://github.com/jinlab-imvr/ReSurgSAM2.

Surgical scene perception via videos are critical for advancing robotic surgery, telesurgery, and AI-assisted surgery, particularly in ophthalmology. However, the scarcity of diverse and richly annotated video datasets has hindered the development of intelligent systems for surgical workflow analysis. Existing datasets for surgical workflow analysis, which typically face challenges such as small scale, a lack of diversity in surgery and phase categories, and the absence of time-localized annotations, limit the requirements for action understanding and model generalization validation in complex and diverse real-world surgical scenarios. To address this gap, we introduce OphNet, a large-scale, expert-annotated video benchmark for ophthalmic surgical workflow understanding. OphNet features: 1) A diverse collection of 2,278 surgical videos spanning 66 types of cataract, glaucoma, and corneal surgeries, with detailed annotations for 102 unique surgical phases and 150 granular operations; 2) It offers sequential and hierarchical annotations for each surgery, phase, and operation, enabling comprehensive understanding and improved interpretability; 3) Moreover, OphNet provides time-localized annotations, facilitating temporal localization and prediction tasks within surgical workflows. With approximately 205 hours of surgical videos, OphNet is about 20 times larger than the largest existing surgical workflow analysis benchmark. Our dataset and code have been made available at: https://github.com/minghu0830/OphNet-benchmark.

Developing embodied AI for intelligent surgical systems requires safe, controllable environments for continual learning and evaluation. However, safety regulations and operational constraints in operating rooms (ORs) limit embodied agents from freely perceiving and interacting in realistic settings. Digital twins provide high-fidelity, risk-free environments for exploration and training. How we may create photorealistic and dynamic digital representations of ORs that capture relevant spatial, visual, and behavioral complexity remains unclear. We introduce TwinOR, a framework for constructing photorealistic, dynamic digital twins of ORs for embodied AI research. The system reconstructs static geometry from pre-scan videos and continuously models human and equipment motion through multi-view perception of OR activities. The static and dynamic components are fused into an immersive 3D environment that supports controllable simulation and embodied exploration. The proposed framework reconstructs complete OR geometry with centimeter level accuracy while preserving dynamic interaction across surgical workflows, enabling realistic renderings and a virtual playground for embodied AI systems. In our experiments, TwinOR simulates stereo and monocular sensor streams for geometry understanding and visual localization tasks. Models such as FoundationStereo and ORB-SLAM3 on TwinOR-synthesized data achieve performance within their reported accuracy on real indoor datasets, demonstrating that TwinOR provides sensor-level realism sufficient for perception and localization challenges. By establishing a real-to-sim pipeline for constructing dynamic, photorealistic digital twins of OR environments, TwinOR enables the safe, scalable, and data-efficient development and benchmarking of embodied AI, ultimately accelerating the deployment of embodied AI from sim-to-real.

We present an algorithm for efficiently exploring inequivalent Calabi-Yau threefold hypersurfaces in toric varieties. A direct enumeration of fine, regular, star triangulations (FRSTs) of polytopes in the Kreuzer-Skarke database is foreseeably impossible due to the large count of distinct FRSTs. Moreover, such an enumeration is needlessly redundant because many such triangulations have the same restrictions to 2-faces and hence, by Wall's theorem, lead to equivalent Calabi-Yau threefolds. We show that this redundancy can be circumvented by finding a height vector in the strict interior of the intersection of the secondary cones associated with each 2-face triangulation. We demonstrate that such triangulations are generated with orders of magnitude fewer operations than the naive approach of generating all FRSTs and selecting only those differing on 2-faces. Similar methods are also presented to directly generate (the support of) the secondary subfan of all fine triangulations, relevant for random sampling of FRSTs.

This work introduces the first framework for reconstructing surgical dialogue from unstructured real-world recordings, which is crucial for characterizing teaching tasks. In surgical training, the formative verbal feedback that trainers provide to trainees during live surgeries is crucial for ensuring safety, correcting behavior immediately, and facilitating long-term skill acquisition. However, analyzing and quantifying this feedback is challenging due to its unstructured and specialized nature. Automated systems are essential to manage these complexities at scale, allowing for the creation of structured datasets that enhance feedback analysis and improve surgical education. Our framework integrates voice activity detection, speaker diarization, and automated speech recaognition, with a novel enhancement that 1) removes hallucinations (non-existent utterances generated during speech recognition fueled by noise in the operating room) and 2) separates speech from trainers and trainees using few-shot voice samples. These aspects are vital for reconstructing accurate surgical dialogues and understanding the roles of operating room participants. Using data from 33 real-world surgeries, we demonstrated the system's capability to reconstruct surgical teaching dialogues and detect feedback instances effectively (F1 score of 0.79+/-0.07). Moreover, our hallucination removal step improves feedback detection performance by ~14%. Evaluation on downstream clinically relevant tasks of predicting Behavioral Adjustment of trainees and classifying Technical feedback, showed performances comparable to manual annotations with F1 scores of 0.82+/0.03 and 0.81+/0.03 respectively. These results highlight the effectiveness of our framework in supporting clinically relevant tasks and improving over manual methods.

Imitation learning has achieved remarkable success in robotic manipulation, yet its application to surgical robotics remains challenging due to data scarcity, constrained workspaces, and the need for an exceptional level of safety and predictability. We present a supervised Mixture-of-Experts (MoE) architecture designed for phase-structured surgical manipulation tasks, which can be added on top of any autonomous policy. Unlike prior surgical robot learning approaches that rely on multi-camera setups or thousands of demonstrations, we show that a lightweight action decoder policy like Action Chunking Transformer (ACT) can learn complex, long-horizon manipulation from less than 150 demonstrations using solely stereo endoscopic images, when equipped with our architecture. We evaluate our approach on the collaborative surgical task of bowel grasping and retraction, where a robot assistant interprets visual cues from a human surgeon, executes targeted grasping on deformable tissue, and performs sustained retraction. We benchmark our method against state-of-the-art Vision-Language-Action (VLA) models and the standard ACT baseline. Our results show that generalist VLAs fail to acquire the task entirely, even under standard in-distribution conditions. Furthermore, while standard ACT achieves moderate success in-distribution, adopting a supervised MoE architecture significantly boosts its performance, yielding higher success rates in-distribution and demonstrating superior robustness in out-of-distribution scenarios, including novel grasp locations, reduced illumination, and partial occlusions. Notably, it generalizes to unseen testing viewpoints and also transfers zero-shot to ex vivo porcine tissue without additional training, offering a promising pathway toward in vivo deployment. To support this, we present qualitative preliminary results of policy roll-outs during in vivo porcine surgery.

Generating accurate 3D reconstructions from endoscopic video is a promising avenue for longitudinal radiation-free analysis of sinus anatomy and surgical outcomes. Several methods for monocular reconstruction have been proposed, yielding visually pleasant 3D anatomical structures by retrieving relative camera poses with structure-from-motion-type algorithms and fusion of monocular depth estimates. However, due to the complex properties of the underlying algorithms and endoscopic scenes, the reconstruction pipeline may perform poorly or fail unexpectedly. Further, acquiring medical data conveys additional challenges, presenting difficulties in quantitatively benchmarking these models, understanding failure cases, and identifying critical components that contribute to their precision. In this work, we perform a quantitative analysis of a self-supervised approach for sinus reconstruction using endoscopic sequences paired with optical tracking and high-resolution computed tomography acquired from nine ex-vivo specimens. Our results show that the generated reconstructions are in high agreement with the anatomy, yielding an average point-to-mesh error of 0.91 mm between reconstructions and CT segmentations. However, in a point-to-point matching scenario, relevant for endoscope tracking and navigation, we found average target registration errors of 6.58 mm. We identified that pose and depth estimation inaccuracies contribute equally to this error and that locally consistent sequences with shorter trajectories generate more accurate reconstructions. These results suggest that achieving global consistency between relative camera poses and estimated depths with the anatomy is essential. In doing so, we can ensure proper synergy between all components of the pipeline for improved reconstructions that will facilitate clinical application of this innovative technology.

Recent breakthroughs in self-supervised learning (SSL), such as the Latent-Euclidean Joint-Embedding Predictive Architecture (LeJEPA), alongside successes in integrating visual encoders with language models, have driven the demand for adaptable, high-capacity vision encoders in Computed Tomography (CT). In this work, we explore 2D slice-based architectures as a flexible alternative to native 3D models for processing volumetric CT data. Using the CT-RATE dataset, we trained DALE-CT (Depth-Aware Latent-Euclidean Computed Tomography), a 2D model family built entirely from scratch using LeJEPA, and compared its performance against a continually pre-trained DINOv2 baseline. To enhance representation quality, we developed a novel 3D depth-aware pre-training strategy anchored by dense auxiliary supervision from both automated anatomical masks and human-annotated abnormalities. Under linear probe evaluation with Multiple Instance Learning (MIL) for multi-abnormality detection, the frozen backbone of this dual-supervised model (DALE-CT-2S) achieves a Macro AUROC of 0.833. This performance demonstrates near-parity with state-of-the-art 3D vision-language models, achieved entirely from scratch with significantly less data and no textual supervision. To ensure reproducibility, all training code, evaluation scripts, and model weights have been made publicly available.

Fully Homomorphic Encryption (FHE) is an encryption scheme that allows for computation to be performed directly on encrypted data, effectively closing the loop on secure and outsourced computing. Data is encrypted not only during rest and transit, but also during processing. However, FHE provides a limited instruction set: SIMD addition, SIMD multiplication, and cyclic rotation of 1-D vectors. This restriction makes performing multi-dimensional tensor operations challenging. Practitioners must pack these tensors into 1-D vectors and map tensor operations onto this one-dimensional layout rather than their traditional nested structure. And while prior systems have made significant strides in automating this process, they often hide critical packing decisions behind layers of abstraction, making debugging, optimizing, and building on top of these systems difficult. In this work, we approach multi-dimensional tensor operations in FHE through Einstein summation (einsum) notation. Einsum notation explicitly encodes dimensional structure and operations in its syntax, naturally exposing how tensors should be packed and transformed. We decompose einsum expressions into a fixed set of FHE-friendly operations. We implement our design and present EinHops, a minimalist system that factors einsum expressions into a fixed sequence of FHE operations. EinHops enables developers to perform encrypted tensor operations using FHE while maintaining full visibility into the underlying packing strategy. We evaluate EinHops on a range of tensor operations from a simple transpose to complex multi-dimensional contractions. We show that the explicit nature of einsum notation allows us to build an FHE tensor system that is simple, general, and interpretable. We open-source EinHops at the following repository: https://github.com/baahl-nyu/einhops.

Vision-language pre-training (VLP) offers unique advantages for surgery by aligning language with surgical videos, enabling workflow understanding and transfer across tasks without relying on expert-labeled datasets. However, progress in surgical VLP remains constrained by the limited scale, procedural diversity, semantic quality, and hierarchical structure of existing datasets. In this work, we present SurgLaVi, the largest and most diverse surgical vision-language dataset to date, comprising nearly 240k clip-caption pairs from more than 200 procedures, and comprising hierarchical levels at phase-, step-, and task-level. At the core of SurgLaVi lies a fully automated pipeline that systematically generates fine-grained transcriptions of surgical videos and segments them into coherent procedural units. To ensure high-quality annotations, it applies dual-modality filtering to remove irrelevant and noisy samples. Within this framework, the resulting captions are enriched with contextual detail, producing annotations that are both semantically rich and easy to interpret. To ensure accessibility, we release SurgLaVi-eta, an open-source derivative of 113k clip-caption pairs constructed entirely from public data, which is over four times larger than existing surgical VLP datasets. To demonstrate the value of SurgLaVi datasets, we introduce SurgCLIP, a CLIP-style video-text contrastive framework with dual encoders, as a representative base model. SurgCLIP achieves consistent improvements across phase, step, action, and tool recognition, surpassing prior state-of-the-art methods, often by large margins. These results validate that large-scale, semantically rich, and hierarchically structured datasets directly translate into stronger and more generalizable representations, establishing SurgLaVi as a key resource for developing surgical foundation models.

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

Crystal structures are characterized by atomic bases within a primitive unit cell that repeats along a regular lattice throughout 3D space. The periodic and infinite nature of crystals poses unique challenges for geometric graph representation learning. Specifically, constructing graphs that effectively capture the complete geometric information of crystals and handle chiral crystals remains an unsolved and challenging problem. In this paper, we introduce a novel approach that utilizes the periodic patterns of unit cells to establish the lattice-based representation for each atom, enabling efficient and expressive graph representations of crystals. Furthermore, we propose ComFormer, a SE(3) transformer designed specifically for crystalline materials. ComFormer includes two variants; namely, iComFormer that employs invariant geometric descriptors of Euclidean distances and angles, and eComFormer that utilizes equivariant vector representations. Experimental results demonstrate the state-of-the-art predictive accuracy of ComFormer variants on various tasks across three widely-used crystal benchmarks. Our code is publicly available as part of the AIRS library (https://github.com/divelab/AIRS).