Daily Papers

Surgical triplet detection has emerged as a pivotal task in surgical video analysis, with significant implications for performance assessment and the training of novice surgeons. However, existing datasets such as CholecT50 exhibit critical limitations: they lack precise spatial bounding box annotations, provide inconsistent and clinically ungrounded temporal labels, and rely on a single data source, which limits model generalizability.To address these shortcomings, we introduce ProstaTD, a large-scale, multi-institutional dataset for surgical triplet detection, developed from the technically demanding domain of robot-assisted prostatectomy. ProstaTD offers clinically defined temporal boundaries and high-precision bounding box annotations for each structured triplet action. The dataset comprises 60,529 video frames and 165,567 annotated triplet instances, collected from 21 surgeries performed across multiple institutions, reflecting a broad range of surgical practices and intraoperative conditions. The annotation process was conducted under rigorous medical supervision and involved more than 50 contributors, including practicing surgeons and medically trained annotators, through multiple iterative phases of labeling and verification. ProstaTD is the largest and most diverse surgical triplet dataset to date, providing a robust foundation for fair benchmarking, the development of reliable surgical AI systems, and scalable tools for procedural training.

Surgical tool segmentation and action recognition are fundamental building blocks in many computer-assisted intervention applications, ranging from surgical skills assessment to decision support systems. Nowadays, learning-based action recognition and segmentation approaches outperform classical methods, relying, however, on large, annotated datasets. Furthermore, action recognition and tool segmentation algorithms are often trained and make predictions in isolation from each other, without exploiting potential cross-task relationships. With the EndoVis 2022 SAR-RARP50 challenge, we release the first multimodal, publicly available, in-vivo, dataset for surgical action recognition and semantic instrumentation segmentation, containing 50 suturing video segments of Robotic Assisted Radical Prostatectomy (RARP). The aim of the challenge is twofold. First, to enable researchers to leverage the scale of the provided dataset and develop robust and highly accurate single-task action recognition and tool segmentation approaches in the surgical domain. Second, to further explore the potential of multitask-based learning approaches and determine their comparative advantage against their single-task counterparts. A total of 12 teams participated in the challenge, contributing 7 action recognition methods, 9 instrument segmentation techniques, and 4 multitask approaches that integrated both action recognition and instrument segmentation. The complete SAR-RARP50 dataset is available at: https://rdr.ucl.ac.uk/projects/SARRARP50_Segmentation_of_surgical_instrumentation_and_Action_Recognition_on_Robot-Assisted_Radical_Prostatectomy_Challenge/191091

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.

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.

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.

Efficiently delivering items to an ongoing surgery in a hospital operating room can be a matter of life or death. In modern hospital settings, delivery robots have successfully transported bulk items between rooms and floors. However, automating item-level operating room logistics presents unique challenges in perception, efficiency, and maintaining sterility. We propose the Operating Room Bot (ORB), a robot framework to automate logistics tasks in hospital operating rooms (OR). ORB leverages a robust, hierarchical behavior tree (BT) architecture to integrate diverse functionalities of object recognition, scene interpretation, and GPU-accelerated motion planning. The contributions of this paper include: (1) a modular software architecture facilitating robust mobile manipulation through behavior trees; (2) a novel real-time object recognition pipeline integrating YOLOv7, Segment Anything Model 2 (SAM2), and Grounded DINO; (3) the adaptation of the cuRobo parallelized trajectory optimization framework to real-time, collision-free mobile manipulation; and (4) empirical validation demonstrating an 80% success rate in OR supply retrieval and a 96% success rate in restocking operations. These contributions establish ORB as a reliable and adaptable system for autonomous OR logistics.

Esophageal cancer is among the most common types of cancer worldwide. It is traditionally treated using open esophagectomy, but in recent years, robot-assisted minimally invasive esophagectomy (RAMIE) has emerged as a promising alternative. However, robot-assisted surgery can be challenging for novice surgeons, as they often suffer from a loss of spatial orientation. Computer-aided anatomy recognition holds promise for improving surgical navigation, but research in this area remains limited. In this study, we developed a comprehensive dataset for semantic segmentation in RAMIE, featuring the largest collection of vital anatomical structures and surgical instruments to date. Handling this diverse set of classes presents challenges, including class imbalance and the recognition of complex structures such as nerves. This study aims to understand the challenges and limitations of current state-of-the-art algorithms on this novel dataset and problem. Therefore, we benchmarked eight real-time deep learning models using two pretraining datasets. We assessed both traditional and attention-based networks, hypothesizing that attention-based networks better capture global patterns and address challenges such as occlusion caused by blood or other tissues. The benchmark includes our RAMIE dataset and the publicly available CholecSeg8k dataset, enabling a thorough assessment of surgical segmentation tasks. Our findings indicate that pretraining on ADE20k, a dataset for semantic segmentation, is more effective than pretraining on ImageNet. Furthermore, attention-based models outperform traditional convolutional neural networks, with SegNeXt and Mask2Former achieving higher Dice scores, and Mask2Former additionally excelling in average symmetric surface distance.

Few foundation models exist for robot-assisted surgery, partly because large robotic-surgery video corpora are difficult to assemble and existing models are evaluated mostly on laparoscopic benchmarks. Further, most existing models are evaluated on a small set of public benchmarks, mostly focused on laparoscopic surgery. We present OmniRAS, a family of 1B- and 2B-parameter V-JEPA-2.1 encoders for robot-assisted surgery, and detail their training. First, we release two densely annotated robotic-cholecystectomy datasets: OmniRAS-PR and a multi-label YT-Chole tool-verb-target task, the first triplet-style annotation for robotic cholecystectomy, together with splits, probe protocols, and an inter-rater study validating the shared phase ontology. Second, we document continued pretraining at up to 256 compute nodes with global batch 6,144 over 19 sources totaling approximately 2,650 hours of surgical video, 51% robotic, and analyze compute and data composition. Third, we evaluate against raw V-JEPA-2.1 and specialized surgical models on six tasks spanning triplet, phase, and step recognition, action segmentation, and detection, under frozen-encoder and final-four-block fine-tuning regimes. Across three seeds, this yields 254 downstream runs, including 109 with partial backbone fine-tuning. The best OmniRAS models achieve the strongest adapted results across all task families, while frozen differences are smaller.

Autonomous medical robots hold promise to improve patient outcomes, reduce provider workload, democratize access to care, and enable superhuman precision. However, autonomous medical robotics has been limited by a fundamental data problem: existing medical robotic datasets are small, single-embodiment, and rarely shared openly, restricting the development of foundation models that the field needs to advance. We introduce Open-H-Embodiment, the largest open dataset of medical robotic video with synchronized kinematics to date, spanning more than 49 institutions and multiple robotic platforms including the CMR Versius, Intuitive Surgical's da Vinci, da Vinci Research Kit (dVRK), Rob Surgical BiTrack, Virtual Incision's MIRA, Moon Surgical Maestro, and a variety of custom systems, spanning surgical manipulation, robotic ultrasound, and endoscopy procedures. We demonstrate the research enabled by this dataset through two foundation models. GR00T-H is the first open foundation vision-language-action model for medical robotics, which is the only evaluated model to achieve full end-to-end task completion on a structured suturing benchmark (25% of trials vs. 0% for all others) and achieves 64% average success across a 29-step ex vivo suturing sequence. We also train Cosmos-H-Surgical-Simulator, the first action-conditioned world model to enable multi-embodiment surgical simulation from a single checkpoint, spanning nine robotic platforms and supporting in silico policy evaluation and synthetic data generation for the medical domain. These results suggest that open, large-scale medical robot data collection can serve as critical infrastructure for the research community, enabling advances in robot learning, world modeling, and beyond.

Ultrasound (US) is a widely used medical imaging modality due to its real-time capabilities, non-invasive nature, and cost-effectiveness. Robotic ultrasound can further enhance its utility by reducing operator dependence and improving access to complex anatomical regions. For this, while deep reinforcement learning (DRL) and imitation learning (IL) have shown potential for autonomous navigation, their use in complex surgical tasks such as anatomy reconstruction and surgical guidance remains limited -- largely due to the lack of realistic and efficient simulation environments tailored to these tasks. We introduce SonoGym, a scalable simulation platform for complex robotic ultrasound tasks that enables parallel simulation across tens to hundreds of environments. Our framework supports realistic and real-time simulation of US data from CT-derived 3D models of the anatomy through both a physics-based and a generative modeling approach. Sonogym enables the training of DRL and recent IL agents (vision transformers and diffusion policies) for relevant tasks in robotic orthopedic surgery by integrating common robotic platforms and orthopedic end effectors. We further incorporate submodular DRL -- a recent method that handles history-dependent rewards -- for anatomy reconstruction and safe reinforcement learning for surgery. Our results demonstrate successful policy learning across a range of scenarios, while also highlighting the limitations of current methods in clinically relevant environments. We believe our simulation can facilitate research in robot learning approaches for such challenging robotic surgery applications. Dataset, codes, and videos are publicly available at https://sonogym.github.io/.

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.

In the realm of automated robotic surgery and computer-assisted interventions, understanding robotic surgical activities stands paramount. Existing algorithms dedicated to surgical activity recognition predominantly cater to pre-defined closed-set paradigms, ignoring the challenges of real-world open-set scenarios. Such algorithms often falter in the presence of test samples originating from classes unseen during training phases. To tackle this problem, we introduce an innovative Open-Set Surgical Activity Recognition (OSSAR) framework. Our solution leverages the hyperspherical reciprocal point strategy to enhance the distinction between known and unknown classes in the feature space. Additionally, we address the issue of over-confidence in the closed set by refining model calibration, avoiding misclassification of unknown classes as known ones. To support our assertions, we establish an open-set surgical activity benchmark utilizing the public JIGSAWS dataset. Besides, we also collect a novel dataset on endoscopic submucosal dissection for surgical activity tasks. Extensive comparisons and ablation experiments on these datasets demonstrate the significant outperformance of our method over existing state-of-the-art approaches. Our proposed solution can effectively address the challenges of real-world surgical scenarios. Our code is publicly accessible at https://github.com/longbai1006/OSSAR.

Robotic-assisted minimally invasive esophagectomy (RAMIE) is a recognized treatment for esophageal cancer, offering better patient outcomes compared to open surgery and traditional minimally invasive surgery. RAMIE is highly complex, spanning multiple anatomical areas and involving repetitive phases and non-sequential phase transitions. Our goal is to leverage deep learning for surgical phase recognition in RAMIE to provide intraoperative support to surgeons. To achieve this, we have developed a new surgical phase recognition dataset comprising 27 videos. Using this dataset, we conducted a comparative analysis of state-of-the-art surgical phase recognition models. To more effectively capture the temporal dynamics of this complex procedure, we developed a novel deep learning model featuring an encoder-decoder structure with causal hierarchical attention, which demonstrates superior performance compared to existing models.

Surgical robotics holds much promise for improving patient safety and clinician experience in the Operating Room (OR). However, it also comes with new challenges, requiring strong team coordination and effective OR management. Automatic detection of surgical activities is a key requirement for developing AI-based intelligent tools to tackle these challenges. The current state-of-the-art surgical activity recognition methods however operate on image-based representations and depend on large-scale labeled datasets whose collection is time-consuming and resource-expensive. This work proposes a new sample-efficient and object-based approach for surgical activity recognition in the OR. Our method focuses on the geometric arrangements between clinicians and surgical devices, thus utilizing the significant object interaction dynamics in the OR. We conduct experiments in a low-data regime study for long video activity recognition. We also benchmark our method againstother object-centric approaches on clip-level action classification and show superior performance.

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.

Learning-based surgical robot autonomy requires large-scale demonstrations with synchronized videos and robot actions, but such data are exceedingly rare in clinical or realistic tissue settings because robot kinematics are typically inaccessible outside controlled research systems. In contrast, phantom data collected on research platforms provide accurate action labels but lack the visual diversity of real tissue. We propose SurgVIL, a framework for scaling surgical robot imitation learning using open-source surgical videos. SurgVIL combines kinematically labeled phantom robot demonstrations with surgical videos from open-source datasets and online sources for policy learning. Since these videos lack robot motion labels, we estimate approximate kinematics as weak supervision. We evaluate SurgVIL on two da Vinci robot tasks: needle pick-up and cholecystectomy cutting. Across ACT, π_0, and GR00T-H backbones, adding surgical videos substantially improves generalization to real-tissue and out-of-distribution settings, suggesting a scalable path from phantom training toward generalizable surgical robot policies.

We explore whether surgical manipulation tasks can be learned on the da Vinci robot via imitation learning. However, the da Vinci system presents unique challenges which hinder straight-forward implementation of imitation learning. Notably, its forward kinematics is inconsistent due to imprecise joint measurements, and naively training a policy using such approximate kinematics data often leads to task failure. To overcome this limitation, we introduce a relative action formulation which enables successful policy training and deployment using its approximate kinematics data. A promising outcome of this approach is that the large repository of clinical data, which contains approximate kinematics, may be directly utilized for robot learning without further corrections. We demonstrate our findings through successful execution of three fundamental surgical tasks, including tissue manipulation, needle handling, and knot-tying.

Surgical robot automation has attracted increasing research interest over the past decade, expecting its potential to benefit surgeons, nurses and patients. Recently, the learning paradigm of embodied intelligence has demonstrated promising ability to learn good control policies for various complex tasks, where embodied AI simulators play an essential role to facilitate relevant research. However, existing open-sourced simulators for surgical robot are still not sufficiently supporting human interactions through physical input devices, which further limits effective investigations on how the human demonstrations would affect policy learning. In this work, we study human-in-the-loop embodied intelligence with a new interactive simulation platform for surgical robot learning. Specifically, we establish our platform based on our previously released SurRoL simulator with several new features co-developed to allow high-quality human interaction via an input device. We showcase the improvement of our simulation environment with the designed new features, and validate effectiveness of incorporating human factors in embodied intelligence through the use of human demonstrations and reinforcement learning as a representative example. Promising results are obtained in terms of learning efficiency. Lastly, five new surgical robot training tasks are developed and released, with which we hope to pave the way for future research on surgical embodied intelligence. Our learning platform is publicly released and will be continuously updated in the website: https://med-air.github.io/SurRoL.

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

The detailed images produced by Magnetic Resonance Imaging (MRI) provide life-critical information for the diagnosis and treatment of prostate cancer. To provide standardized acquisition, interpretation and usage of the complex MRI images, the PI-RADS v2 guideline was proposed. An automated segmentation following the guideline facilitates consistent and precise lesion detection, staging and treatment. The guideline recommends a division of the prostate into four zones, PZ (peripheral zone), TZ (transition zone), DPU (distal prostatic urethra) and AFS (anterior fibromuscular stroma). Not every zone shares a boundary with the others and is present in every slice. Further, the representations captured by a single model might not suffice for all zones. This motivated us to design a dual-branch convolutional neural network (CNN), where each branch captures the representations of the connected zones separately. Further, the representations from different branches act complementary to each other at the second stage of training, where they are fine-tuned through an unsupervised loss. The loss penalises the difference in predictions from the two branches for the same class. We also incorporate multi-task learning in our framework to further improve the segmentation accuracy. The proposed approach improves the segmentation accuracy of the baseline (mean absolute symmetric distance) by 7.56%, 11.00%, 58.43% and 19.67% for PZ, TZ, DPU and AFS zones respectively.

In recent years, the application of machine learning to minimally invasive surgery (MIS) has attracted considerable interest. Datasets are critical to the use of such techniques. This paper presents a unique dataset recorded during ex vivo pseudo-cholecystectomy procedures on pig livers using the da Vinci Research Kit (dVRK). Unlike existing datasets, it addresses a critical gap by providing comprehensive kinematic data, recordings of all pedal inputs, and offers a time-stamped record of the endoscope's movements. This expanded version also includes segmentation and keypoint annotations of images, enhancing its utility for computer vision applications. Contributed by seven surgeons with varied backgrounds and experience levels that are provided as a part of this expanded version, the dataset is an important new resource for surgical robotics research. It enables the development of advanced methods for evaluating surgeon skills, tools for providing better context awareness, and automation of surgical tasks. Our work overcomes the limitations of incomplete recordings and imprecise kinematic data found in other datasets. To demonstrate the potential of the dataset for advancing automation in surgical robotics, we introduce two models that predict clutch usage and camera activation, a 3D scene reconstruction example, and the results from our keypoint and segmentation models.

This paper presents the Holistic and Multi-Granular Surgical Scene Understanding of Prostatectomies (GraSP) dataset, a curated benchmark that models surgical scene understanding as a hierarchy of complementary tasks with varying levels of granularity. Our approach encompasses long-term tasks, such as surgical phase and step recognition, and short-term tasks, including surgical instrument segmentation and atomic visual actions detection. To exploit our proposed benchmark, we introduce the Transformers for Actions, Phases, Steps, and Instrument Segmentation (TAPIS) model, a general architecture that combines a global video feature extractor with localized region proposals from an instrument segmentation model to tackle the multi-granularity of our benchmark. Through extensive experimentation in ours and alternative benchmarks, we demonstrate TAPIS's versatility and state-of-the-art performance across different tasks. This work represents a foundational step forward in Endoscopic Vision, offering a novel framework for future research towards holistic surgical scene understanding.

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.

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.

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.

Surgical phase recognition is a basic component for different context-aware applications in computer- and robot-assisted surgery. In recent years, several methods for automatic surgical phase recognition have been proposed, showing promising results. However, a meaningful comparison of these methods is difficult due to differences in the evaluation process and incomplete reporting of evaluation details. In particular, the details of metric computation can vary widely between different studies. To raise awareness of potential inconsistencies, this paper summarizes common deviations in the evaluation of phase recognition algorithms on the Cholec80 benchmark. In addition, a structured overview of previously reported evaluation results on Cholec80 is provided, taking known differences in evaluation protocols into account. Greater attention to evaluation details could help achieve more consistent and comparable results on the surgical phase recognition task, leading to more reliable conclusions about advancements in the field and, finally, translation into clinical practice.

We use a Stochastic Hybrid Automaton (SHA) model of prostate cancer evolution under intermittent androgen suppression (IAS) to study a threshold-based policy for therapy design. IAS is currently one of the most widely used treatments for advanced prostate cancer. Patients undergoing IAS are submitted to cycles of treatment (in the form of androgen deprivation) and off-treatment periods in an alternating manner. One of the main challenges in IAS is to optimally design a therapy scheme, i.e., to determine when to discontinue and recommence androgen suppression. The level of prostate specific antigen (PSA) in a patient's serum is frequently monitored to determine when the patient will be taken off therapy and when therapy will resume. The threshold-based policy we propose is parameterized by lower and upper PSA threshold values and is associated with a cost metric that combines clinically relevant measures of therapy success. Using Infinitesimal Perturbation Analysis (IPA), we derive unbiased gradient estimators of this cost metric with respect to the controllable PSA threshold values based on actual data and show how these estimators can be used to adaptively adjust controllable parameters so as to improve therapy outcomes based on the cost metric defined.

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.

Multiparametric magnetic resonance imaging (mpMRI) has demonstrated promising results in prostate cancer (PCa) detection using deep convolutional neural networks (CNNs). Recently, transformers have achieved competitive performance compared to CNNs in computer vision. Large-scale transformers need abundant annotated data for training, which are difficult to obtain in medical imaging. Self-supervised learning can effectively leverage unlabeled data to extract useful semantic representations without annotation and its associated costs. This can improve model performance on downstream tasks with limited labelled data and increase generalizability. We introduce a novel end-to-end Cross-Shaped windows (CSwin) transformer UNet model, CSwin UNet, to detect clinically significant prostate cancer (csPCa) in prostate bi-parametric MR imaging (bpMRI) and demonstrate the effectiveness of our proposed self-supervised pre-training framework. Using a large prostate bpMRI dataset with 1500 patients, we first pre-train CSwin transformer using multi-task self-supervised learning to improve data-efficiency and network generalizability. We then finetuned using lesion annotations to perform csPCa detection. Five-fold cross validation shows that self-supervised CSwin UNet achieves 0.888 AUC and 0.545 Average Precision (AP), significantly outperforming four state-of-the-art models (Swin UNETR, DynUNet, Attention UNet, UNet). Using a separate bpMRI dataset with 158 patients, we evaluated our model robustness to external hold-out data. Self-supervised CSwin UNet achieves 0.79 AUC and 0.45 AP, still outperforming all other comparable methods and demonstrating generalization to a dataset shift.

Prostate cancer is one of the most common and lethal cancers among men, making its early detection critically important. Although ultrasound imaging offers greater accessibility and cost-effectiveness compared to MRI, traditional transrectal ultrasound methods suffer from low sensitivity, especially in detecting anteriorly located tumors. Ultrasound computed tomography provides quantitative tissue characterization, but its clinical implementation faces significant challenges, particularly under anatomically constrained limited-angle acquisition conditions specific to prostate imaging. To address these unmet needs, we introduce OpenPros, the first large-scale benchmark dataset explicitly developed for limited-view prostate USCT. Our dataset includes over 280,000 paired samples of realistic 2D speed-of-sound (SOS) phantoms and corresponding ultrasound full-waveform data, generated from anatomically accurate 3D digital prostate models derived from real clinical MRI/CT scans and ex vivo ultrasound measurements, annotated by medical experts. Simulations are conducted under clinically realistic configurations using advanced finite-difference time-domain and Runge-Kutta acoustic wave solvers, both provided as open-source components. Through comprehensive baseline experiments, we demonstrate that state-of-the-art deep learning methods surpass traditional physics-based approaches in both inference efficiency and reconstruction accuracy. Nevertheless, current deep learning models still fall short of delivering clinically acceptable high-resolution images with sufficient accuracy. By publicly releasing OpenPros, we aim to encourage the development of advanced machine learning algorithms capable of bridging this performance gap and producing clinically usable, high-resolution, and highly accurate prostate ultrasound images. The dataset is publicly accessible at https://open-pros.github.io/.

In recent years, the potential applications of machine learning to Minimally Invasive Surgery (MIS) have spurred interest in data sets that can be used to develop data-driven tools. This paper introduces a novel dataset recorded during ex vivo pseudo-cholecystectomy procedures on pig livers, utilizing the da Vinci Research Kit (dVRK). Unlike current datasets, ours bridges a critical gap by offering not only full kinematic data but also capturing all pedal inputs used during the procedure and providing a time-stamped record of the endoscope's movements. Contributed by seven surgeons, this data set introduces a new dimension to surgical robotics research, allowing the creation of advanced models for automating console functionalities. Our work addresses the existing limitation of incomplete recordings and imprecise kinematic data, common in other datasets. By introducing two models, dedicated to predicting clutch usage and camera activation, we highlight the dataset's potential for advancing automation in surgical robotics. The comparison of methodologies and time windows provides insights into the models' boundaries and limitations.

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.

Accurate prostate cancer diagnosis remains challenging. Even when using MRI, radiologists exhibit low specificity and significant inter-observer variability, leading to potential delays or inaccuracies in identifying clinically significant cancers. This leads to numerous unnecessary biopsies and risks of missing clinically significant cancers. Here we present prostate vision contrastive network (ProViCNet), prostate organ-specific vision foundation models for Magnetic Resonance Imaging (MRI) and Trans-Rectal Ultrasound imaging (TRUS) for comprehensive cancer detection. ProViCNet was trained and validated using 4,401 patients across six institutions, as a prostate cancer detection model on radiology images relying on patch-level contrastive learning guided by biopsy confirmed radiologist annotations. ProViCNet demonstrated consistent performance across multiple internal and external validation cohorts with area under the receiver operating curve values ranging from 0.875 to 0.966, significantly outperforming radiologists in the reader study (0.907 versus 0.805, p<0.001) for mpMRI, while achieving 0.670 to 0.740 for TRUS. We also integrated ProViCNet with standard PSA to develop a virtual screening test, and we showed that we can maintain the high sensitivity for detecting clinically significant cancers while more than doubling specificity from 15% to 38% (p<0.001), thereby substantially reducing unnecessary biopsies. These findings highlight that ProViCNet's potential for enhancing prostate cancer diagnosis accuracy and reduce unnecessary biopsies, thereby optimizing diagnostic pathways.

Robotic ultrasound couples a high-rate contact-force loop with slower, delayed image feedback, so image-guided ultrasound probe rotation can perturb contact force before the resulting image response is observed. We derive a closed-form orientation-rate limit that bounds the modeled rotation-induced estimated-force excursion over a finite horizon while accounting for disturbance rejection by the fast force loop. The limit depends on local contact stiffness, force-loop gains, a conservative rotation-to-force gain bound, the excursion budget, and the prediction horizon. We implement this model in a dual-rate controller with timestamp-based delay reconstruction and joint-torque-based force estimation, and evaluate it on a curved gelatin phantom using paired controller comparisons and component ablations. Relative to unconstrained image guidance, the proposed rate-limited controller reduced first-second root-mean-square (RMS) estimated-force error by 0.40 N while increasing cue-convergence time by 0.94 s. A fixed rate cap near the analytically predicted ceiling produced no resolvable difference in force error and converged 0.32 s faster, indicating that the principal practical value of the model is the rate-design rule rather than online prediction. Delay reconstruction had no resolvable effect at the tested latency. A single-subject popliteal scan demonstrated feasibility, although the image cue was noise-limited on heterogeneous tissue.

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.

Prostate cancer, a growing global health concern, necessitates precise diagnostic tools, with Magnetic Resonance Imaging (MRI) offering high-resolution soft tissue imaging that significantly enhances diagnostic accuracy. Recent advancements in explainable AI and representation learning have significantly improved prostate cancer diagnosis by enabling automated and precise lesion classification. However, existing explainable AI methods, particularly those based on frameworks like generative adversarial networks (GANs), are predominantly developed for natural image generation, and their application to medical imaging often leads to suboptimal performance due to the unique characteristics and complexity of medical image. To address these challenges, our paper introduces three key contributions. First, we propose ProjectedEx, a generative framework that provides interpretable, multi-attribute explanations, effectively linking medical image features to classifier decisions. Second, we enhance the encoder module by incorporating feature pyramids, which enables multiscale feedback to refine the latent space and improves the quality of generated explanations. Additionally, we conduct comprehensive experiments on both the generator and classifier, demonstrating the clinical relevance and effectiveness of ProjectedEx in enhancing interpretability and supporting the adoption of AI in medical settings. Code will be released at https://github.com/Richardqiyi/ProjectedEx

Minimally invasive and robot-assisted surgery relies heavily on endoscopic imaging, yet surgical smoke produced by electrocautery and vessel-sealing instruments can severely degrade visual perception and hinder vision-based functionalities. We present a transformer-based surgical desmoking model with a physics-inspired desmoking head that jointly predicts smoke-free image and corresponding smoke map. To address the scarcity of paired smoky-to-smoke-free training data, we develop a synthetic data generation pipeline that blends artificial smoke patterns with real endoscopic images, yielding over 80,000 paired samples for supervised training. We further curate, to our knowledge, the largest paired surgical smoke dataset to date, comprising 5,817 image pairs captured with the da Vinci robotic surgical system, enabling benchmarking on high-resolution endoscopic images. Extensive experiments on both a public benchmark and our dataset demonstrate state-of-the-art performance in image reconstruction compared to existing dehazing and desmoking approaches. We also assess the impact of desmoking on downstream stereo depth estimation and instrument segmentation, highlighting both the potential benefits and current limitations of digital smoke removal methods.

Accurate prediction of biochemical recurrence (BCR) after radical prostatectomy is critical for guiding adjuvant treatment and surveillance decisions in prostate cancer. However, existing clinicopathological risk models reduce complex morphology to relatively coarse descriptors, leaving substantial prognostic information embedded in routine histopathology underexplored. We present a deep learning-based biomarker that predicts continuous, patient-specific risk of BCR directly from H&E-stained whole-slide prostatectomy specimens. Trained end-to-end on time-to-event outcomes and evaluated across four independent international cohorts, our model demonstrates robust generalization across institutions and patient populations. When integrated with the CAPRA-S clinical risk score, the deep learning risk score consistently improved discrimination for BCR, increasing concordance indices from 0.725-0.772 to 0.749-0.788 across cohorts. To support clinical interpretability, outcome-grounded analyses revealed subtle histomorphological patterns associated with recurrence risk that are not captured by conventional clinicopathological risk scores. This multicohort study demonstrates that deep learning applied to routine prostate histopathology can deliver reproducible and clinically generalizable biomarkers that augment postoperative risk stratification, with potential to support personalized management of prostate cancer in real-world clinical settings.

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.

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.

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.

Robotic manipulators are increasingly used to assist individuals with mobility impairments in object retrieval. However, the predominant joystick-based control interfaces can be challenging due to high precision requirements and unintuitive reference frames. Recent advances in human-robot interaction have explored alternative modalities, yet many solutions still rely on external screens or restrictive control schemes, limiting their intuitiveness and accessibility. To address these challenges, we present an egocentric, gaze-guided robotic manipulation interface that leverages a wearable Mixed Reality (MR) headset. Our system enables users to interact seamlessly with real-world objects using natural gaze fixation from a first-person perspective, while providing augmented visual cues to confirm intent and leveraging a pretrained vision model and robotic arm for intent recognition and object manipulation. Experimental results demonstrate that our approach significantly improves manipulation accuracy, reduces system latency, and achieves single-pass intention and object recognition accuracy greater than 88% across multiple real-world scenarios. These results demonstrate the system's effectiveness in enhancing intuitiveness and accessibility, underscoring its practical significance for assistive robotics applications.

Recently, Multimodal Large Language Models (MLLMs) have demonstrated their immense potential in computer-aided diagnosis and decision-making. In the context of robotic-assisted surgery, MLLMs can serve as effective tools for surgical training and guidance. However, there is still a lack of MLLMs specialized for surgical scene understanding in clinical applications. In this work, we introduce EndoChat to address various dialogue paradigms and subtasks in surgical scene understanding that surgeons encounter. To train our EndoChat, we construct the Surg-396K dataset through a novel pipeline that systematically extracts surgical information and generates structured annotations based on collected large-scale endoscopic surgery datasets. Furthermore, we introduce a multi-scale visual token interaction mechanism and a visual contrast-based reasoning mechanism to enhance the model's representation learning and reasoning capabilities. Our model achieves state-of-the-art performance across five dialogue paradigms and eight surgical scene understanding tasks. Additionally, we conduct evaluations with professional surgeons, most of whom provide positive feedback on collaborating with EndoChat. Overall, these results demonstrate that our EndoChat has great potential to significantly advance training and automation in robotic-assisted surgery.

Cancer is a complex disease, the understanding and treatment of which are being aided through increases in the volume of collected data and in the scale of deployed computing power. Consequently, there is a growing need for the development of data-driven and, in particular, deep learning methods for various tasks such as cancer diagnosis, detection, prognosis, and prediction. Despite recent successes, however, designing high-performing deep learning models for nonimage and nontext cancer data is a time-consuming, trial-and-error, manual task that requires both cancer domain and deep learning expertise. To that end, we develop a reinforcement-learning-based neural architecture search to automate deep-learning-based predictive model development for a class of representative cancer data. We develop custom building blocks that allow domain experts to incorporate the cancer-data-specific characteristics. We show that our approach discovers deep neural network architectures that have significantly fewer trainable parameters, shorter training time, and accuracy similar to or higher than those of manually designed architectures. We study and demonstrate the scalability of our approach on up to 1,024 Intel Knights Landing nodes of the Theta supercomputer at the Argonne Leadership Computing Facility.

When developing deep neural networks for segmenting intraoperative ultrasound images, several practical issues are encountered frequently, such as the presence of ultrasound frames that do not contain regions of interest and the high variance in ground-truth labels. In this study, we evaluate the utility of a pre-screening classification network prior to the segmentation network. Experimental results demonstrate that such a classifier, minimising frame classification errors, was able to directly impact the number of false positive and false negative frames. Importantly, the segmentation accuracy on the classifier-selected frames, that would be segmented, remains comparable to or better than those from standalone segmentation networks. Interestingly, the efficacy of the pre-screening classifier was affected by the sampling methods for training labels from multiple observers, a seemingly independent problem. We show experimentally that a previously proposed approach, combining random sampling and consensus labels, may need to be adapted to perform well in our application. Furthermore, this work aims to share practical experience in developing a machine learning application that assists highly variable interventional imaging for prostate cancer patients, to present robust and reproducible open-source implementations, and to report a set of comprehensive results and analysis comparing these practical, yet important, options in a real-world clinical application.

Safety limitations in service robotics across various industries have raised significant concerns about the need for robust mechanisms ensuring that robots adhere to safe practices, thereby preventing actions that might harm humans or cause property damage. Despite advances, including the integration of Knowledge Graphs (KGs) with Large Language Models (LLMs), challenges in ensuring consistent safety in autonomous robot actions persist. In this paper, we propose a novel integration of Large Language Models with Embodied Robotic Control Prompts (ERCPs) and Embodied Knowledge Graphs (EKGs) to enhance the safety framework for service robots. ERCPs are designed as predefined instructions that ensure LLMs generate safe and precise responses. These responses are subsequently validated by EKGs, which provide a comprehensive knowledge base ensuring that the actions of the robot are continuously aligned with safety protocols, thereby promoting safer operational practices in varied contexts. Our experimental setup involved diverse real-world tasks, where robots equipped with our framework demonstrated significantly higher compliance with safety standards compared to traditional methods. This integration fosters secure human-robot interactions and positions our methodology at the forefront of AI-driven safety innovations in service robotics.

In this work, we take aim towards increasing the effectiveness of surgical assistant robots. We intended to make assistant robots safer by making them aware about the actions of surgeon, so it can take appropriate assisting actions. In other words, we aim to solve the problem of surgeon action detection in endoscopic videos. To this, we introduce a challenging dataset for surgeon action detection in real-world endoscopic videos. Action classes are picked based on the feedback of surgeons and annotated by medical professional. Given a video frame, we draw bounding box around surgical tool which is performing action and label it with action label. Finally, we presenta frame-level action detection baseline model based on recent advances in ob-ject detection. Results on our new dataset show that our presented dataset provides enough interesting challenges for future method and it can serveas strong benchmark corresponding research in surgeon action detection in endoscopic videos.

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.

Screwdriving is one of the most popular industrial processes. As such, it is increasingly common to automate that procedure by using various robots. Even though the automation increases the efficiency of the screwdriving process, if the process is not monitored correctly, faults may occur during operation, which can impact the effectiveness and quality of assembly. Machine Learning (ML) has the potential to detect those undesirable events and limit their impact. In order to do so, first a dataset that fully describes the operation of an industrial robot performing automated screwdriving must be available. This report describes a dataset created using a UR3e series robot and OnRobot Screwdriver. We create different scenarios and introduce 4 types of anomalies to the process while all available robot and screwdriver sensors are continuously recorded. The resulting data contains 2042 samples of normal and anomalous robot operation. Brief ML benchmarks using this data are also provided, showcasing the data's suitability and potential for further analysis and experimentation.

In recent years, significant progress has been made in the field of robotic reinforcement learning (RL), enabling methods that handle complex image observations, train in the real world, and incorporate auxiliary data, such as demonstrations and prior experience. However, despite these advances, robotic RL remains hard to use. It is acknowledged among practitioners that the particular implementation details of these algorithms are often just as important (if not more so) for performance as the choice of algorithm. We posit that a significant challenge to widespread adoption of robotic RL, as well as further development of robotic RL methods, is the comparative inaccessibility of such methods. To address this challenge, we developed a carefully implemented library containing a sample efficient off-policy deep RL method, together with methods for computing rewards and resetting the environment, a high-quality controller for a widely-adopted robot, and a number of challenging example tasks. We provide this library as a resource for the community, describe its design choices, and present experimental results. Perhaps surprisingly, we find that our implementation can achieve very efficient learning, acquiring policies for PCB board assembly, cable routing, and object relocation between 25 to 50 minutes of training per policy on average, improving over state-of-the-art results reported for similar tasks in the literature. These policies achieve perfect or near-perfect success rates, extreme robustness even under perturbations, and exhibit emergent recovery and correction behaviors. We hope that these promising results and our high-quality open-source implementation will provide a tool for the robotics community to facilitate further developments in robotic RL. Our code, documentation, and videos can be found at https://serl-robot.github.io/

Automatically recognizing surgical gestures is a crucial step towards a thorough understanding of surgical skill. Possible areas of application include automatic skill assessment, intra-operative monitoring of critical surgical steps, and semi-automation of surgical tasks. Solutions that rely only on the laparoscopic video and do not require additional sensor hardware are especially attractive as they can be implemented at low cost in many scenarios. However, surgical gesture recognition based only on video is a challenging problem that requires effective means to extract both visual and temporal information from the video. Previous approaches mainly rely on frame-wise feature extractors, either handcrafted or learned, which fail to capture the dynamics in surgical video. To address this issue, we propose to use a 3D Convolutional Neural Network (CNN) to learn spatiotemporal features from consecutive video frames. We evaluate our approach on recordings of robot-assisted suturing on a bench-top model, which are taken from the publicly available JIGSAWS dataset. Our approach achieves high frame-wise surgical gesture recognition accuracies of more than 84%, outperforming comparable models that either extract only spatial features or model spatial and low-level temporal information separately. For the first time, these results demonstrate the benefit of spatiotemporal CNNs for video-based surgical gesture recognition.

Current robotic evaluation is still largely dominated by binary success rates, which collapse rich execution processes into a single outcome and obscure critical qualities such as progress, efficiency, and stability. To address this limitation, we propose PRM-as-a-Judge, a dense evaluation paradigm that leverages Process Reward Models (PRMs) to audit policy execution directly from trajectory videos by estimating task progress from observation sequences. Central to this paradigm is the OPD (Outcome-Process-Diagnosis) metric system, which explicitly formalizes execution quality via a task-aligned progress potential. We characterize dense robotic evaluation through two axiomatic properties: macro-consistency, which requires additive and path-consistent aggregation, and micro-resolution, which requires sensitivity to fine-grained physical evolution. Under this formulation, potential-based PRM judges provide a natural instantiation of dense evaluation, with macro-consistency following directly from the induced scalar potential. We empirically validate the micro-resolution property using RoboPulse, a diagnostic benchmark specifically designed for probing micro-scale progress discrimination, where several trajectory-trained PRM judges outperform discriminative similarity-based methods and general-purpose foundation-model judges. Finally, leveraging PRM-as-a-Judge and the OPD metric system, we conduct a structured audit of mainstream policy paradigms across long-horizon tasks, revealing behavioral signatures and failure modes that are invisible to outcome-only metrics.

In mainstream computer vision and machine learning, public datasets such as ImageNet, COCO and KITTI have helped drive enormous improvements by enabling researchers to understand the strengths and limitations of different algorithms via performance comparison. However, this type of approach has had limited translation to problems in robotic assisted surgery as this field has never established the same level of common datasets and benchmarking methods. In 2015 a sub-challenge was introduced at the EndoVis workshop where a set of robotic images were provided with automatically generated annotations from robot forward kinematics. However, there were issues with this dataset due to the limited background variation, lack of complex motion and inaccuracies in the annotation. In this work we present the results of the 2017 challenge on robotic instrument segmentation which involved 10 teams participating in binary, parts and type based segmentation of articulated da Vinci robotic instruments.

Nanorobots are a promising development in targeted drug delivery and the treatment of neurological disorders, with potential for crossing the blood-brain barrier (BBB). These small devices leverage advancements in nanotechnology and bioengineering for precise navigation and targeted payload delivery, particularly for conditions like brain tumors, Alzheimer's disease, and Parkinson's disease. Recent progress in artificial intelligence (AI) and machine learning (ML) has improved the navigation and effectiveness of nanorobots, allowing them to detect and interact with cancer cells through biomarker analysis. This study presents a new reinforcement learning (RL) framework for optimizing nanorobot navigation in complex biological environments, focusing on cancer cell detection by analyzing the concentration gradients of surrounding biomarkers. We utilize a computer simulation model to explore the behavior of nanorobots in a three-dimensional space with cancer cells and biological barriers. The proposed method uses Q-learning to refine movement strategies based on real-time biomarker concentration data, enabling nanorobots to autonomously navigate to cancerous tissues for targeted drug delivery. This research lays the groundwork for future laboratory experiments and clinical applications, with implications for personalized medicine and less invasive cancer treatments. The integration of intelligent nanorobots could revolutionize therapeutic strategies, reducing side effects and enhancing treatment effectiveness for cancer patients. Further research will investigate the practical deployment of these technologies in medical settings, aiming to unlock the full potential of nanorobotics in healthcare.

Analyzing outcomes in long-term cancer survivor studies can be complex. The effects of predictors on the failure process may be difficult to assess over longer periods of time, as the commonly used assumption of proportionality of hazards holding over an extended period is often questionable. In this manuscript, we compare seven different survival models that estimate the hazard rate and the effects of proportional and non-proportional covariates. In particular, we focus on an extension of the the multi-resolution hazard (MRH) estimator, combining a non-proportional hierarchical MRH approach with a data-driven pruning algorithm that allows for computational efficiency and produces robust estimates even in times of few observed failures. Using data from a large-scale randomized prostate cancer clinical trial, we examine patterns of biochemical failure and estimate the time-varying effects of androgen deprivation therapy treatment and other covariates. We compare the impact of different modeling strategies and smoothness assumptions on the estimated treatment effect. Our results show that the benefits of treatment diminish over time, possibly with implications for future treatment protocols.

In dynamic operational environments, particularly in collaborative robotics, the inevitability of failures necessitates robust and adaptable recovery strategies. Traditional automated recovery strategies, while effective for predefined scenarios, often lack the flexibility required for on-the-fly task management and adaptation to expected failures. Addressing this gap, we propose a novel approach that models recovery behaviors as adaptable robotic skills, leveraging the Behavior Trees and Motion Generators~(BTMG) framework for policy representation. This approach distinguishes itself by employing reinforcement learning~(RL) to dynamically refine recovery behavior parameters, enabling a tailored response to a wide array of failure scenarios with minimal human intervention. We assess our methodology through a series of progressively challenging scenarios within a peg-in-a-hole task, demonstrating the approach's effectiveness in enhancing operational efficiency and task success rates in collaborative robotics settings. We validate our approach using a dual-arm KUKA robot.

The PI-CAI (Prostate Imaging: Cancer AI) challenge led to expert-level diagnostic algorithms for clinically significant prostate cancer detection. The algorithms receive biparametric MRI scans as input, which consist of T2-weighted and diffusion-weighted scans. These scans can be misaligned due to multiple factors in the scanning process. Image registration can alleviate this issue by predicting the deformation between the sequences. We investigate the effect of image registration on the diagnostic performance of AI-based prostate cancer diagnosis. First, the image registration algorithm, developed in MeVisLab, is analyzed using a dataset with paired lesion annotations. Second, the effect on diagnosis is evaluated by comparing case-level cancer diagnosis performance between using the original dataset, rigidly aligned diffusion-weighted scans, or deformably aligned diffusion-weighted scans. Rigid registration showed no improvement. Deformable registration demonstrated a substantial improvement in lesion overlap (+10% median Dice score) and a positive yet non-significant improvement in diagnostic performance (+0.3% AUROC, p=0.18). Our investigation shows that a substantial improvement in lesion alignment does not directly lead to a significant improvement in diagnostic performance. Qualitative analysis indicated that jointly developing image registration methods and diagnostic AI algorithms could enhance diagnostic accuracy and patient outcomes.

This paper describes the Inria team's integrated robotics system used in the 1st euROBIN coopetition, during which service robots performed voice-activated household tasks in a kitchen setting.The team developed a modified Tiago++ platform that leverages a whole-body control stack for autonomous and teleoperated modes, and an LLM-based pipeline for instruction understanding and task planning. The key contributions (opens-sourced) are the integration of these components and the design of custom teleoperation devices, addressing practical challenges in the deployment of service robots.

Intermittent Androgen Suppression (IAS) is a treatment strategy for delaying or even preventing time to relapse of advanced prostate cancer. IAS consists of alternating cycles of therapy (in the form of androgen suppression) and off-treatment periods. The level of prostate specific antigen (PSA) in a patient's serum is frequently monitored to determine when the patient will be taken off therapy and when therapy will resume. In spite of extensive recent clinical experience with IAS, the design of an ideal protocol for any given patient remains one of the main challenges associated with effectively implementing this therapy. We use a threshold-based policy for optimal IAS therapy design that is parameterized by lower and upper PSA threshold values and is associated with a cost metric that combines clinically relevant measures of therapy success. We apply Infinitesimal Perturbation Analysis (IPA) to a Stochastic Hybrid Automaton (SHA) model of prostate cancer evolution under IAS and derive unbiased estimators of the cost metric gradient with respect to various model and therapy parameters. These estimators are subsequently used for system analysis. By evaluating sensitivity estimates with respect to several model parameters, we identify critical parameters and demonstrate that relaxing the optimality condition in favor of increased robustness to modeling errors provides an alternative objective to therapy design for at least some patients.

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.

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.

Computer-assisted surgery has been developed to enhance surgery correctness and safety. However, researchers and engineers suffer from limited annotated data to develop and train better algorithms. Consequently, the development of fundamental algorithms such as Simultaneous Localization and Mapping (SLAM) is limited. This article elaborates on the efforts of preparing the dataset for semantic segmentation, which is the foundation of many computer-assisted surgery mechanisms. Based on the Cholec80 dataset [3], we extracted 8,080 laparoscopic cholecystectomy image frames from 17 video clips in Cholec80 and annotated the images. The dataset is named CholecSeg8K and its total size is 3GB. Each of these images is annotated at pixel-level for thirteen classes, which are commonly founded in laparoscopic cholecystectomy surgery. CholecSeg8k is released under the license CC BY- NC-SA 4.0.

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.

Despite the many recent achievements in developing and deploying social robotics, there are still many underexplored environments and applications for which systematic evaluation of such systems by end-users is necessary. While several robotic platforms have been used in gerontological healthcare, the question of whether or not a social interactive robot with multi-modal conversational capabilities will be useful and accepted in real-life facilities is yet to be answered. This paper is an attempt to partially answer this question, via two waves of experiments with patients and companions in a day-care gerontological facility in Paris with a full-sized humanoid robot endowed with social and conversational interaction capabilities. The software architecture, developed during the H2020 SPRING project, together with the experimental protocol, allowed us to evaluate the acceptability (AES) and usability (SUS) with more than 60 end-users. Overall, the users are receptive to this technology, especially when the robot perception and action skills are robust to environmental clutter and flexible to handle a plethora of different interactions.

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.

Injury to the cervical spinal cord can cause quadriplegia, impairing muscle function in all four limbs. People with impaired hand function and mobility encounter significant difficulties in carrying out essential self-care and household tasks. Despite the impairment of their neural drive, their volitional myoelectric activity is often partially preserved. High-density electromyography (HDEMG) can detect this myoelectric activity, which can serve as control inputs to assistive devices. Previous HDEMG-controlled robotic interfaces have primarily been limited to controlling table-mounted robot arms. These have constrained reach capabilities. Instead, the ability to control mobile manipulators, which have no such workspace constraints, could allow individuals with quadriplegia to perform a greater variety of assistive tasks, thus restoring independence and reducing caregiver workload. In this study, we introduce a non-invasive wearable HDEMG interface with real-time myoelectric hand gesture recognition, enabling both coarse and fine control over the intricate mobility and manipulation functionalities of an 8 degree-of-freedom mobile manipulator. Our evaluation, involving 13 participants engaging in challenging self-care and household activities, demonstrates the potential of our wearable HDEMG system to profoundly enhance user independence by enabling non-invasive control of a mobile manipulator.

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

Uncertainty in perception, actuation, and the environment often require multiple attempts for a robotic task to be successful. We study a class of problems providing (1) low-entropy indicators of terminal success / failure, and (2) unreliable (high-entropy) data to predict the final outcome of an ongoing task. Examples include a robot trying to connect with a charging station, parallel parking, or assembling a tightly-fitting part. The ability to restart after predicting failure early, versus simply running to failure, can significantly decrease the makespan, that is, the total time to completion, with the drawback of potentially short-cutting an otherwise successful operation. Assuming task running times to be Poisson distributed, and using a Markov Jump process to capture the dynamics of the underlying Markov Decision Process, we derive a closed form solution that predicts makespan based on the confusion matrix of the failure predictor. This allows the robot to learn failure prediction in a production environment, and only adopt a preemptive policy when it actually saves time. We demonstrate this approach using a robotic peg-in-hole assembly problem using a real robotic system. Failures are predicted by a dilated convolutional network based on force-torque data, showing an average makespan reduction from 101s to 81s (N=120, p<0.05). We posit that the proposed algorithm generalizes to any robotic behavior with an unambiguous terminal reward, with wide ranging applications on how robots can learn and improve their behaviors in the wild.

Assistive robotics and particularly robot coaches may be very helpful for rehabilitation healthcare. In this context, we propose a method based on Gaussian Process Latent Variable Model (GP-LVM) to transfer knowledge between a physiotherapist, a robot coach and a patient. Our model is able to map visual human body features to robot data in order to facilitate the robot learning and imitation. In addition , we propose to extend the model to adapt robots' understanding to patient's physical limitations during the assessment of rehabilitation exercises. Experimental evaluation demonstrates promising results for both robot imitation and model adaptation according to the patients' limitations.

This paper presents a novel approach in autonomous robot control, named LLM-BRAIn, that makes possible robot behavior generation, based on operator's commands. LLM-BRAIn is a transformer-based Large Language Model (LLM) fine-tuned from Stanford Alpaca 7B model to generate robot behavior tree (BT) from the text description. We train the LLM-BRAIn on 8,5k instruction-following demonstrations, generated in the style of self-instruct using text-davinchi-003. The developed model accurately builds complex robot behavior while remaining small enough to be run on the robot's onboard microcomputer. The model gives structural and logical correct BTs and can successfully manage instructions that were not presented in training set. The experiment did not reveal any significant subjective differences between BTs generated by LLM-BRAIn and those created by humans (on average, participants were able to correctly distinguish between LLM-BRAIn generated BTs and human-created BTs in only 4.53 out of 10 cases, indicating that their performance was close to random chance). The proposed approach potentially can be applied to mobile robotics, drone operation, robot manipulator systems and Industry 4.0.

Early tumor detection save lives. Each year, more than 300 million computed tomography (CT) scans are performed worldwide, offering a vast opportunity for effective cancer screening. However, detecting small or early-stage tumors on these CT scans remains challenging, even for experts. Artificial intelligence (AI) models can assist by highlighting suspicious regions, but training such models typically requires extensive tumor masks--detailed, voxel-wise outlines of tumors manually drawn by radiologists. Drawing these masks is costly, requiring years of effort and millions of dollars. In contrast, nearly every CT scan in clinical practice is already accompanied by medical reports describing the tumor's size, number, appearance, and sometimes, pathology results--information that is rich, abundant, and often underutilized for AI training. We introduce R-Super, which trains AI to segment tumors that match their descriptions in medical reports. This approach scales AI training with large collections of readily available medical reports, substantially reducing the need for manually drawn tumor masks. When trained on 101,654 reports, AI models achieved performance comparable to those trained on 723 masks. Combining reports and masks further improved sensitivity by +13% and specificity by +8%, surpassing radiologists in detecting five of the seven tumor types. Notably, R-Super enabled segmentation of tumors in the spleen, gallbladder, prostate, bladder, uterus, and esophagus, for which no public masks or AI models previously existed. This study challenges the long-held belief that large-scale, labor-intensive tumor mask creation is indispensable, establishing a scalable and accessible path toward early detection across diverse tumor types. We plan to release our trained models, code, and dataset at https://github.com/MrGiovanni/R-Super

Surgical phase recognition has gained significant attention due to its potential to offer solutions to numerous demands of the modern operating room. However, most existing methods concentrate on minimally invasive surgery (MIS), leaving surgical phase recognition for open surgery understudied. This discrepancy is primarily attributed to the scarcity of publicly available open surgery video datasets for surgical phase recognition. To address this issue, we introduce a new egocentric open surgery video dataset for phase recognition, named EgoSurgery-Phase. This dataset comprises 15 hours of real open surgery videos spanning 9 distinct surgical phases all captured using an egocentric camera attached to the surgeon's head. In addition to video, the EgoSurgery-Phase offers eye gaze. As far as we know, it is the first real open surgery video dataset for surgical phase recognition publicly available. Furthermore, inspired by the notable success of masked autoencoders (MAEs) in video understanding tasks (e.g., action recognition), we propose a gaze-guided masked autoencoder (GGMAE). Considering the regions where surgeons' gaze focuses are often critical for surgical phase recognition (e.g., surgical field), in our GGMAE, the gaze information acts as an empirical semantic richness prior to guiding the masking process, promoting better attention to semantically rich spatial regions. GGMAE significantly improves the previous state-of-the-art recognition method (6.4% in Jaccard) and the masked autoencoder-based method (3.1% in Jaccard) on EgoSurgery-Phase. The dataset is released at https://github.com/Fujiry0/EgoSurgery.

Intra-operative recognition of surgical phases holds significant potential for enhancing real-time contextual awareness in the operating room. However, we argue that online recognition, while beneficial, primarily lends itself to post-operative video analysis due to its limited direct impact on the actual surgical decisions and actions during ongoing procedures. In contrast, we contend that the prediction and anticipation of surgical phases are inherently more valuable for intra-operative assistance, as they can meaningfully influence a surgeon's immediate and long-term planning by providing foresight into future steps. To address this gap, we propose a dual approach that simultaneously recognises the current surgical phase and predicts upcoming ones, thus offering comprehensive intra-operative assistance and guidance on the expected remaining workflow. Our novel method, Surgical Phase Recognition and Anticipation (SuPRA), leverages past and current information for accurate intra-operative phase recognition while using future segments for phase prediction. This unified approach challenges conventional frameworks that treat these objectives separately. We have validated SuPRA on two reputed datasets, Cholec80 and AutoLaparo21, where it demonstrated state-of-the-art performance with recognition accuracies of 91.8% and 79.3%, respectively. Additionally, we introduce and evaluate our model using new segment-level evaluation metrics, namely Edit and F1 Overlap scores, for a more temporal assessment of segment classification. In conclusion, SuPRA presents a new multi-task approach that paves the way for improved intra-operative assistance through surgical phase recognition and prediction of future events.

The rising number of the elderly incurs growing concern about healthcare, and in particular rehabilitation healthcare. Assistive technology and assistive robotics in particular may help to improve this process. We develop a robot coach capable of demonstrating rehabilitation exercises to patients, watch a patient carry out the exercises and give him feedback so as to improve his performance and encourage him. The HRI of the system is based on our study with a team of rehabilitation therapists and with the target population.The system relies on human motion analysis. We develop a method for learning a probabilistic representation of ideal movements from expert demonstrations. A Gaussian Mixture Model is employed from position and orientation features captured using a Microsoft Kinect v2. For assessing patients' movements, we propose a real-time multi-level analysis to both temporally and spatially identify and explain body part errors. This analysis combined with a classification algorithm allows the robot to provide coaching advice to make the patient improve his movements. The evaluation on three rehabilitation exercises shows the potential of the proposed approach for learning and assessing kinaesthetic movements.

Building general-purpose robots that can operate seamlessly, in any environment, with any object, and utilizing various skills to complete diverse tasks has been a long-standing goal in Artificial Intelligence. Unfortunately, however, most existing robotic systems have been constrained - having been designed for specific tasks, trained on specific datasets, and deployed within specific environments. These systems usually require extensively-labeled data, rely on task-specific models, have numerous generalization issues when deployed in real-world scenarios, and struggle to remain robust to distribution shifts. Motivated by the impressive open-set performance and content generation capabilities of web-scale, large-capacity pre-trained models (i.e., foundation models) in research fields such as Natural Language Processing (NLP) and Computer Vision (CV), we devote this survey to exploring (i) how these existing foundation models from NLP and CV can be applied to the field of robotics, and also exploring (ii) what a robotics-specific foundation model would look like. We begin by providing an overview of what constitutes a conventional robotic system and the fundamental barriers to making it universally applicable. Next, we establish a taxonomy to discuss current work exploring ways to leverage existing foundation models for robotics and develop ones catered to robotics. Finally, we discuss key challenges and promising future directions in using foundation models for enabling general-purpose robotic systems. We encourage readers to view our ``living`` GitHub repository of resources, including papers reviewed in this survey as well as related projects and repositories for developing foundation models for robotics.

In this paper we present the Yale-CMU-Berkeley (YCB) Object and Model set, intended to be used to facilitate benchmarking in robotic manipulation, prosthetic design and rehabilitation research. The objects in the set are designed to cover a wide range of aspects of the manipulation problem; it includes objects of daily life with different shapes, sizes, textures, weight and rigidity, as well as some widely used manipulation tests. The associated database provides high-resolution RGBD scans, physical properties, and geometric models of the objects for easy incorporation into manipulation and planning software platforms. In addition to describing the objects and models in the set along with how they were chosen and derived, we provide a framework and a number of example task protocols, laying out how the set can be used to quantitatively evaluate a range of manipulation approaches including planning, learning, mechanical design, control, and many others. A comprehensive literature survey on existing benchmarks and object datasets is also presented and their scope and limitations are discussed. The set will be freely distributed to research groups worldwide at a series of tutorials at robotics conferences, and will be otherwise available at a reasonable purchase cost. It is our hope that the ready availability of this set along with the ground laid in terms of protocol templates will enable the community of manipulation researchers to more easily compare approaches as well as continually evolve benchmarking tests as the field matures.

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.

Recent advancements in robotics have enabled robots to navigate complex scenes or manipulate diverse objects independently. However, robots are still impotent in many household tasks requiring coordinated behaviors such as opening doors. The factorization of navigation and manipulation, while effective for some tasks, fails in scenarios requiring coordinated actions. To address this challenge, we introduce, HarmonicMM, an end-to-end learning method that optimizes both navigation and manipulation, showing notable improvement over existing techniques in everyday tasks. This approach is validated in simulated and real-world environments and adapts to novel unseen settings without additional tuning. Our contributions include a new benchmark for mobile manipulation and the successful deployment with only RGB visual observation in a real unseen apartment, demonstrating the potential for practical indoor robot deployment in daily life. More results are on our project site: https://rchalyang.github.io/HarmonicMM/

Robots are becoming more capable and can autonomously perform tasks such as navigating between locations. However, human oversight remains crucial. This study compared two touchless methods for directing mobile robots: voice control and gesture control, to investigate the efficiency of the methods and the preference of users. We tested these methods in two conditions: one in which participants remained stationary and one in which they walked freely alongside the robot. We hypothesized that walking alongside the robot would result in higher intuitiveness ratings and improved task performance, based on the idea that walking promotes spatial alignment and reduces the effort required for mental rotation. In a 2x2 within-subject design, 218 participants guided the quadruped robot Spot along a circuitous route with multiple 90-degree turns using rotate left, rotate right, and walk forward commands. After each trial, participants rated the intuitiveness of the command mapping, while post-experiment interviews were used to gather the participants' preferences. Results showed that voice control combined with walking with Spot was the most favored and intuitive, whereas gesture control while standing caused confusion for left/right commands. Nevertheless, 29% of participants preferred gesture control, citing increased task engagement and visual congruence as reasons. An odometry-based analysis revealed that participants often followed behind Spot, particularly in the gesture control condition, when they were allowed to walk. In conclusion, voice control with walking produced the best outcomes. Improving physical ergonomics and adjusting gesture types could make gesture control more effective.

In this work, we study how to build a robotic system that can solve multiple 3D manipulation tasks given language instructions. To be useful in industrial and household domains, such a system should be capable of learning new tasks with few demonstrations and solving them precisely. Prior works, like PerAct and RVT, have studied this problem, however, they often struggle with tasks requiring high precision. We study how to make them more effective, precise, and fast. Using a combination of architectural and system-level improvements, we propose RVT-2, a multitask 3D manipulation model that is 6X faster in training and 2X faster in inference than its predecessor RVT. RVT-2 achieves a new state-of-the-art on RLBench, improving the success rate from 65% to 82%. RVT-2 is also effective in the real world, where it can learn tasks requiring high precision, like picking up and inserting plugs, with just 10 demonstrations. Visual results, code, and trained model are provided at: https://robotic-view-transformer-2.github.io/.

Generative simulation for surgical robotics still lacks real-time interaction. Physical-robot experiments, often involving animal or cadaver labs, are time-consuming, costly, and difficult to reproduce, while classical simulators struggle to capture photorealistic appearance and deformable-tissue dynamics. We address this gap with Cosmos-H-Dreams, an integrated real-time surgical world-model system combining an action-conditioned generative model, a teacher-to-student distillation recipe, and a deployment stack built on the NVIDIA FlashDreams streaming-inference library. Starting from Cosmos-H-Surgical-Simulator, a multi-embodiment action-conditioned surgical video world model fine-tuned on the large-scale Open-H-Embodiment corpus, we post-train this checkpoint on embodiment- and procedure-specific data. By distilling the resulting bidirectional teacher into a causal, few-step student with Self Forcing, we turn a passive video generator into a controllable surgical simulator that streams at sim160 inference FPS on a single NVIDIA RTX PRO 6000 Blackwell workstation GPU. Crucially, Cosmos-H-Dreams is controller-agnostic: any interface that emits a stream of robot kinematics can drive it. We demonstrate live control through a browser keyboard over WebRTC, a Meta Quest headset over WebXR, a commercial surgical robot console such as CMR Surgical's Versius, and learned policies operating in closed loop. To our knowledge, this is the first interactive surgical world model supporting live human and policy control. Human operators and policies alike can act inside the synthesized world and observe the consequences in real time. We release Cosmos-H-Dreams as an open surgical simulation system, providing a common foundation for surgical education, scalable synthetic data generation, and future intraoperative decision support.

Developing a general robot manipulation system capable of performing a wide range of tasks in complex, dynamic, and unstructured real-world environments has long been a challenging task. It is widely recognized that achieving human-like efficiency and robustness manipulation requires the robotic brain to integrate a comprehensive set of functions, such as task planning, policy generation, anomaly monitoring and handling, and long-term memory, achieving high-efficiency operation across all functions. Vision-Language Models (VLMs), pretrained on massive multimodal data, have acquired rich world knowledge, exhibiting exceptional scene understanding and multimodal reasoning capabilities. However, existing methods typically focus on realizing only a single function or a subset of functions within the robotic brain, without integrating them into a unified cognitive architecture. Inspired by a divide-and-conquer strategy and the architecture of the human brain, we propose FrankenBot, a VLM-driven, brain-morphic robotic manipulation framework that achieves both comprehensive functionality and high operational efficiency. Our framework includes a suite of components, decoupling a part of key functions from frequent VLM calls, striking an optimal balance between functional completeness and system efficiency. Specifically, we map task planning, policy generation, memory management, and low-level interfacing to the cortex, cerebellum, temporal lobe-hippocampus complex, and brainstem, respectively, and design efficient coordination mechanisms for the modules. We conducted comprehensive experiments in both simulation and real-world robotic environments, demonstrating that our method offers significant advantages in anomaly detection and handling, long-term memory, operational efficiency, and stability -- all without requiring any fine-tuning or retraining.

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 advances in frontier AI models have demonstrated remarkable capabilities in visual understanding, reasoning, planning, and tool use, raising the possibility of using general-purpose AI models for robot manipulation without task-specific training. However, their manipulation capabilities have not been systematically evaluated on standardized robotics benchmarks. In this report, we present a unified closed-loop manipulation framework for evaluating frontier AI models on the LIBERO-10 benchmark. Our framework enables models to control a robot directly through visual observations, robot proprioception, and structured tool calls, primarily by specifying target end-effector poses and gripper commands, without task-specific fine-tuning or pretrained manipulation skills. We evaluate six frontier AI models, including GPT-6 Astra, GPT-6.1 Sol, GPT-6 Luna, Claude Opus 5, Claude Opus 5.5, and Gemini-4 Argon, across three reasoning effort levels, resulting in 18 configurations and 1,800 evaluation episodes. Our results show that GPT-6 Astra achieves the highest success rate of 44%, followed by Gemini-4 Argon at 43%. Increasing reasoning effort generally improves manipulation performance, but the benefits vary across models and come at additional inference cost. We also observe substantial differences across tasks, with models performing relatively well on object placement tasks but struggling with precise spatial arrangements and complex multi-step interactions. These findings demonstrate both the potential and limitations of frontier AI models for robot manipulation, highlighting the challenges of translating reasoning capabilities into reliable physical actions. We release our evaluation framework and experimental results to support reproducible benchmarking and future research on reasoning-based robot manipulation.

Histology review is often used as the `gold standard' for disease diagnosis. Computer aided diagnosis tools can potentially help improve current pathology workflows by reducing examination time and interobserver variability. Previous work in cancer grading has focused mainly on classifying pre-defined regions of interest (ROIs), or relied on large amounts of fine-grained labels. In this paper, we propose a two-stage attention-based multiple instance learning model for slide-level cancer grading and weakly-supervised ROI detection and demonstrate its use in prostate cancer. Compared with existing Gleason classification models, our model goes a step further by utilizing visualized saliency maps to select informative tiles for fine-grained grade classification. The model was primarily developed on a large-scale whole slide dataset consisting of 3,521 prostate biopsy slides with only slide-level labels from 718 patients. The model achieved state-of-the-art performance for prostate cancer grading with an accuracy of 85.11\% for classifying benign, low-grade (Gleason grade 3+3 or 3+4), and high-grade (Gleason grade 4+3 or higher) slides on an independent test set.

Accurate segmentation of thin structures is critical for microsurgical scene understanding but remains challenging due to resolution loss, low contrast, and class imbalance. We propose Microsurgery Instrument Segmentation for Robotic Assistance(MISRA), a segmentation framework that augments RGB input with luminance channels, integrates skip attention to preserve elongated features, and employs an Iterative Feedback Module(IFM) for continuity restoration across multiple passes. In addition, we introduce a dedicated microsurgical dataset with fine-grained annotations of surgical instruments including thin objects, providing a benchmark for robust evaluation Dataset available at https://huggingface.co/datasets/KIST-HARILAB/MISAW-Seg. Experiments demonstrate that MISRA achieves competitive performance, improving the mean class IoU by 5.37% over competing methods, while delivering more stable predictions at instrument contacts and overlaps. These results position MISRA as a promising step toward reliable scene parsing for computer-assisted and robotic microsurgery.

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.

Radiotherapy (RT) planning is complex, subjective, and time-intensive. Advances in artificial intelligence (AI) promise to improve its precision, efficiency, and consistency, but progress is often limited by the scarcity of large, standardized datasets. To address this, we introduce the Automated Iterative RT Planning (AIRTP) system, a scalable solution for generating high-quality treatment plans. This scalable solution is designed to generate substantial volumes of consistently high-quality treatment plans, overcoming a key obstacle in the advancement of AI-driven RT planning. Our AIRTP pipeline adheres to clinical guidelines and automates essential steps, including organ-at-risk (OAR) contouring, helper structure creation, beam setup, optimization, and plan quality improvement, using AI integrated with RT planning software like Eclipse of Varian. Furthermore, a novel approach for determining optimization parameters to reproduce 3D dose distributions, i.e. a method to convert dose predictions to deliverable treatment plans constrained by machine limitations. A comparative analysis of plan quality reveals that our automated pipeline produces treatment plans of quality comparable to those generated manually, which traditionally require several hours of labor per plan. Committed to public research, the first data release of our AIRTP pipeline includes nine cohorts covering head-and-neck and lung cancer sites to support an AAPM 2025 challenge. This data set features more than 10 times the number of plans compared to the largest existing well-curated public data set to our best knowledge. Repo:{https://github.com/RiqiangGao/GDP-HMM_AAPMChallenge}

Owing to recent advances in machine learning and the ability to harvest large amounts of data during robotic-assisted surgeries, surgical data science is ripe for foundational work. We present a large dataset of surgical videos and their accompanying labels for this purpose. We describe how the data was collected and some of its unique attributes. Multiple example problems are outlined. Although the dataset was curated for a particular set of scientific challenges (in an accompanying paper), it is general enough to be used for a broad range machine learning questions. Our hope is that this dataset exposes the larger machine learning community to the challenging problems within surgical data science, and becomes a touch-stone for future research. The videos are available at https://storage.googleapis.com/isi-surgvu/surgvu24_videos_only.zip, the labels at https://storage.googleapis.com/isi-surgvu/surgvu24_labels_updated_v2.zip, a validation set for tool detection problem at https://storage.googleapis.com/isi-surgvu/cat1_test_set_public.zip, and a sample set of question & answer pairs dataset for surgical visual question answering at https://storage.googleapis.com/isi-surgvu/SURGVU25_cat_2_sample_set_public.zip.

Robotics is undergoing a significant transformation powered by advances in high-level control techniques based on machine learning, giving rise to the field of robot learning. Recent progress in robot learning has been accelerated by the increasing availability of affordable teleoperation systems, large-scale openly available datasets, and scalable learning-based methods. However, development in the field of robot learning is often slowed by fragmented, closed-source tools designed to only address specific sub-components within the robotics stack. In this paper, we present lerobot, an open-source library that integrates across the entire robot learning stack, from low-level middleware communication for motor controls to large-scale dataset collection, storage and streaming. The library is designed with a strong focus on real-world robotics, supporting accessible hardware platforms while remaining extensible to new embodiments. It also supports efficient implementations for various state-of-the-art robot learning algorithms from multiple prominent paradigms, as well as a generalized asynchronous inference stack. Unlike traditional pipelines which heavily rely on hand-crafted techniques, lerobot emphasizes scalable learning approaches that improve directly with more data and compute. Designed for accessibility, scalability, and openness, lerobot lowers the barrier to entry for researchers and practitioners to robotics while providing a platform for reproducible, state-of-the-art robot learning.

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.

Operating robots precisely and at high speeds has been a long-standing goal of robotics research. Balancing these competing demands is key to enabling the seamless collaboration of robots and humans and increasing task performance. However, traditional motor-driven systems often fall short in this balancing act. Due to their rigid and often heavy design exacerbated by positioning the motors into the joints, faster motions of such robots transfer high forces at impact. To enable precise and safe dynamic motions, we introduce a four degree-of-freedom~(DoF) tendon-driven robot arm. Tendons allow placing the actuation at the base to reduce the robot's inertia, which we show significantly reduces peak collision forces compared to conventional robots with motors placed near the joints. Pairing our robot with pneumatic muscles allows generating high forces and highly accelerated motions, while benefiting from impact resilience through passive compliance. Since tendons are subject to additional friction and hence prone to wear and tear, we validate the reliability of our robotic arm on various experiments, including long-term dynamic motions. We also demonstrate its ease of control by quantifying the nonlinearities of the system and the performance on a challenging dynamic table tennis task learned from scratch using reinforcement learning. We open-source the entire hardware design, which can be largely 3D printed, the control software, and a proprioceptive dataset of 25 days of diverse robot motions at webdav.tuebingen.mpg.de/pamy2.

Tool use is a hallmark of advanced intelligence, exemplified in both animal behavior and robotic capabilities. This paper investigates the feasibility of imbuing robots with the ability to creatively use tools in tasks that involve implicit physical constraints and long-term planning. Leveraging Large Language Models (LLMs), we develop RoboTool, a system that accepts natural language instructions and outputs executable code for controlling robots in both simulated and real-world environments. RoboTool incorporates four pivotal components: (i) an "Analyzer" that interprets natural language to discern key task-related concepts, (ii) a "Planner" that generates comprehensive strategies based on the language input and key concepts, (iii) a "Calculator" that computes parameters for each skill, and (iv) a "Coder" that translates these plans into executable Python code. Our results show that RoboTool can not only comprehend explicit or implicit physical constraints and environmental factors but also demonstrate creative tool use. Unlike traditional Task and Motion Planning (TAMP) methods that rely on explicit optimization, our LLM-based system offers a more flexible, efficient, and user-friendly solution for complex robotics tasks. Through extensive experiments, we validate that RoboTool is proficient in handling tasks that would otherwise be infeasible without the creative use of tools, thereby expanding the capabilities of robotic systems. Demos are available on our project page: https://creative-robotool.github.io/.

Robotic manipulation, owing to its multi-modal nature, often faces significant training ambiguity, necessitating explicit instructions to clearly delineate the manipulation details in tasks. In this work, we highlight that vision instruction is naturally more comprehensible to recent robotic policies than the commonly adopted text instruction, as these policies are born with some vision understanding ability like human infants. Building on this premise and drawing inspiration from cognitive science, we introduce the robotic imagery paradigm, which realizes large-scale robotic data pre-training without text annotations. Additionally, we propose the robotic gaze strategy that emulates the human eye gaze mechanism, thereby guiding subsequent actions and focusing the attention of the policy on the manipulated object. Leveraging these innovations, we develop VIRT, a fully Transformer-based policy. We design comprehensive tasks using both a physical robot and simulated environments to assess the efficacy of VIRT. The results indicate that VIRT can complete very competitive tasks like ``opening the lid of a tightly sealed bottle'', and the proposed techniques boost the success rates of the baseline policy on diverse challenging tasks from nearly 0% to more than 65%.

In recent years roboticists have achieved remarkable progress in solving increasingly general tasks on dexterous robotic hardware by leveraging high capacity Transformer network architectures and generative diffusion models. Unfortunately, combining these two orthogonal improvements has proven surprisingly difficult, since there is no clear and well-understood process for making important design choices. In this paper, we identify, study and improve key architectural design decisions for high-capacity diffusion transformer policies. The resulting models can efficiently solve diverse tasks on multiple robot embodiments, without the excruciating pain of per-setup hyper-parameter tuning. By combining the results of our investigation with our improved model components, we are able to present a novel architecture, named \method, that significantly outperforms the state of the art in solving long-horizon (1500+ time-steps) dexterous tasks on a bi-manual ALOHA robot. In addition, we find that our policies show improved scaling performance when trained on 10 hours of highly multi-modal, language annotated ALOHA demonstration data. We hope this work will open the door for future robot learning techniques that leverage the efficiency of generative diffusion modeling with the scalability of large scale transformer architectures. Code, robot dataset, and videos are available at: https://dit-policy.github.io

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.

Recently, the advent of pre-trained large-scale language models (LLMs) like ChatGPT and GPT-4 have significantly advanced the machine's natural language understanding capabilities. This breakthrough has allowed us to seamlessly integrate these open-source LLMs into a unified robot simulator environment to help robots accurately understand and execute human natural language instructions. To this end, in this work, we introduce a realistic robotic manipulation simulator and build a Robotic Manipulation with Progressive Reasoning Tasks (RM-PRT) benchmark on this basis. Specifically, the RM-PRT benchmark builds a new high-fidelity digital twin scene based on Unreal Engine 5, which includes 782 categories, 2023 objects, and 15K natural language instructions generated by ChatGPT for a detailed evaluation of robot manipulation. We propose a general pipeline for the RM-PRT benchmark that takes as input multimodal prompts containing natural language instructions and automatically outputs actions containing the movement and position transitions. We set four natural language understanding tasks with progressive reasoning levels and evaluate the robot's ability to understand natural language instructions in two modes of adsorption and grasping. In addition, we also conduct a comprehensive analysis and comparison of the differences and advantages of 10 different LLMs in instruction understanding and generation quality. We hope the new simulator and benchmark will facilitate future research on language-guided robotic manipulation. Project website: https://necolizer.github.io/RM-PRT/ .

We describe a mobile manipulation hardware and software system capable of autonomously performing complex human-level tasks in real homes, after being taught the task with a single demonstration from a person in virtual reality. This is enabled by a highly capable mobile manipulation robot, whole-body task space hybrid position/force control, teaching of parameterized primitives linked to a robust learned dense visual embeddings representation of the scene, and a task graph of the taught behaviors. We demonstrate the robustness of the approach by presenting results for performing a variety of tasks, under different environmental conditions, in multiple real homes. Our approach achieves 85% overall success rate on three tasks that consist of an average of 45 behaviors each.

During lung radiotherapy, the position of infrared reflective objects on the chest can be recorded to estimate the tumor location. However, radiotherapy systems have a latency inherent to robot control limitations that impedes the radiation delivery precision. Prediction with online learning of recurrent neural networks (RNN) allows for adaptation to non-stationary respiratory signals, but classical methods such as RTRL and truncated BPTT are respectively slow and biased. This study investigates the capabilities of unbiased online recurrent optimization (UORO) to forecast respiratory motion and enhance safety in lung radiotherapy. We used 9 observation records of the 3D position of 3 external markers on the chest and abdomen of healthy individuals breathing during intervals from 73s to 222s. The sampling frequency was 10Hz, and the amplitudes of the recorded trajectories range from 6mm to 40mm in the superior-inferior direction. We forecast the 3D location of each marker simultaneously with a horizon value between 0.1s and 2.0s, using an RNN trained with UORO. We compare its performance with an RNN trained with RTRL, LMS, and offline linear regression. We provide closed-form expressions for quantities involved in the loss gradient calculation in UORO, thereby making its implementation efficient. Training and cross-validation were performed during the first minute of each sequence. On average over the horizon values considered and the 9 sequences, UORO achieves the lowest root-mean-square (RMS) error and maximum error among the compared algorithms. These errors are respectively equal to 1.3mm and 8.8mm, and the prediction time per time step was lower than 2.8ms (Dell Intel core i9-9900K 3.60 GHz). Linear regression has the lowest RMS error for the horizon values 0.1s and 0.2s, followed by LMS for horizon values between 0.3s and 0.5s, and UORO for horizon values greater than 0.6s.

Robotics can help address the growing worker shortage challenge of the manufacturing industry. As such, machine tending is a task collaborative robots can tackle that can also highly boost productivity. Nevertheless, existing robotics systems deployed in that sector rely on a fixed single-arm setup, whereas mobile robots can provide more flexibility and scalability. In this work, we introduce a multi-agent multi-machine tending learning framework by mobile robots based on Multi-agent Reinforcement Learning (MARL) techniques with the design of a suitable observation and reward. Moreover, an attention-based encoding mechanism is developed and integrated into Multi-agent Proximal Policy Optimization (MAPPO) algorithm to boost its performance for machine tending scenarios. Our model (AB-MAPPO) outperformed MAPPO in this new challenging scenario in terms of task success, safety, and resources utilization. Furthermore, we provided an extensive ablation study to support our various design decisions.

Reliable pelvic bone segmentation (PBS) from CT is essential for robot-assisted pelvic trauma surgery, yet deploying a source-trained model to a new hospital suffers from severe performance degradation due to cross-center domain shifts. While test-time adaptation (TTA) enables online model adaptation without accessing source data, existing methods show limited effectiveness for PBS, facing challenges including boundary degradation, anatomical inconsistency under domain shifts, and voxel-level class imbalance. To address these challenges, we propose a novel closed-loop dynamic Reliability-Guided TTA framework (ReGA) for PBS. Specifically, we introduce a pseudo-label reliability criterion termed Segmentation Inference Consistency Evaluation (SICE), which jointly measures region overlap and boundary deviation via dropout-based ensemble predictions. Based on SICE, a trust-weighted refinement module adaptively updates features to mitigate boundary errors in pseudo-labels. Furthermore, a confidence-weighted region-level contrastive learning strategy is proposed to enforce anatomical consistency. Finally, ReGA follows the teacher-student (TS) scheme to alleviate voxel-level class imbalance. Experiments on three heterogeneous 3D pelvic CT datasets demonstrate that ReGA consistently outperforms state-of-the-art TTA methods, enabling effective adaptation of the source-trained PBS model to unseen clinical domains. The code is available at https://github.com/Ren-ling/ReGA.

Robotic assembly is one of the oldest and most challenging applications of robotics. In other areas of robotics, such as perception and grasping, simulation has rapidly accelerated research progress, particularly when combined with modern deep learning. However, accurately, efficiently, and robustly simulating the range of contact-rich interactions in assembly remains a longstanding challenge. In this work, we present Factory, a set of physics simulation methods and robot learning tools for such applications. We achieve real-time or faster simulation of a wide range of contact-rich scenes, including simultaneous simulation of 1000 nut-and-bolt interactions. We provide 60 carefully-designed part models, 3 robotic assembly environments, and 7 robot controllers for training and testing virtual robots. Finally, we train and evaluate proof-of-concept reinforcement learning policies for nut-and-bolt assembly. We aim for Factory to open the doors to using simulation for robotic assembly, as well as many other contact-rich applications in robotics. Please see https://sites.google.com/nvidia.com/factory for supplementary content, including videos.

When adapting Vision Language Action (VLA) models to downstream tasks, multiple rounds of post-training are often required to progressively address policy weaknesses. In this report, we focus on maximizing human efficiency during this iterative process, measured by policy improvement and task throughput per unit of human labor and time. We propose HELP, a Human-Efficient Large-scale robot Post-training pipeline in which two specialized operators supervise twelve robots concurrently. A trained Teleoperator provides high-value remote interventions and recovery demonstrations, while a Floor Operator monitors the robot fleet, triggers takeovers, and performs physical resets. This role specialization improves human efficiency by reducing task switching, lowering operator training costs, and expanding robot interaction coverage. Beyond increasing rollout volume, concurrent supervision also broadens the range of policy behaviors observed by the human team, making recurring failure modes easier to identify and enabling more targeted takeovers, resets, and recovery demonstrations. To efficiently utilize the large and mixed-quality rollout data, HELP incorporates \vlac, an automatic rollout segmentation critic specifically designed for this setting. It separates autonomous trajectories into progress-making, idle, failure-inducing, and recovery segments. Useful rollout segments are retained and combined with Human-in-the-Loop data for the next post-training round. Across four real-world manipulation tasks, HELP achieves 80\%--95\% success rates and improves task throughput by 1.7times--4.2times over the base model. Under matched HITL recovery budgets, VLAC-CUT further amplifies throughput gains by 1.20times--3.43times and success-rate gains by 1.50times--3.00times over HITL-only updates.

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.

Robotic manipulation remains a core challenge in robotics, particularly for contact-rich tasks such as industrial assembly and disassembly. Existing datasets have significantly advanced learning in manipulation but are primarily focused on simpler tasks like object rearrangement, falling short of capturing the complexity and physical dynamics involved in assembly and disassembly. To bridge this gap, we present REASSEMBLE (Robotic assEmbly disASSEMBLy datasEt), a new dataset designed specifically for contact-rich manipulation tasks. Built around the NIST Assembly Task Board 1 benchmark, REASSEMBLE includes four actions (pick, insert, remove, and place) involving 17 objects. The dataset contains 4,551 demonstrations, of which 4,035 were successful, spanning a total of 781 minutes. Our dataset features multi-modal sensor data, including event cameras, force-torque sensors, microphones, and multi-view RGB cameras. This diverse dataset supports research in areas such as learning contact-rich manipulation, task condition identification, action segmentation, and task inversion learning. The REASSEMBLE will be a valuable resource for advancing robotic manipulation in complex, real-world scenarios. The dataset is publicly available on our project website: https://tuwien-asl.github.io/REASSEMBLE_page/.

Imitation learning enables robots to acquire manipulation skills from demonstrations, yet deploying a policy across tasks with heterogeneous dynamics remains challenging, as models tend to average over distinct behavioral modes present in the demonstrations. Mixture-of-Experts (MoE) architectures address this by activating specialized subnetworks, but requires meaningful skill decompositions for expert routing. We introduce Latent-Aligned Routing for Mixture of Experts (LAR-MoE), a two-stage framework that decouples unsupervised skill discovery from policy learning. In pre-training, we learn a joint latent representation between observations and future actions through student-teacher co-training. In a post-training stage, the expert routing is regularized to follow the structure of the learned latent space, preventing expert collapse while maintaining parameter efficiency. We evaluate LAR-MoE in simulation and on hardware. On the LIBERO benchmark, our method achieves a 95.2% average success rate with 150M parameters. On a surgical bowel grasping and retraction task, LAR-MoE matches a supervised MoE baseline without requiring any phase annotations, and transfers zero-shot to ex vivo porcine tissue. Our findings suggest that latent-aligned routing provides a principled alternative to supervised skill decomposition, enabling structured expert specialization from unlabeled demonstrations.

Reinforcement learning (RL) holds great promise for enabling autonomous acquisition of complex robotic manipulation skills, but realizing this potential in real-world settings has been challenging. We present a human-in-the-loop vision-based RL system that demonstrates impressive performance on a diverse set of dexterous manipulation tasks, including dynamic manipulation, precision assembly, and dual-arm coordination. Our approach integrates demonstrations and human corrections, efficient RL algorithms, and other system-level design choices to learn policies that achieve near-perfect success rates and fast cycle times within just 1 to 2.5 hours of training. We show that our method significantly outperforms imitation learning baselines and prior RL approaches, with an average 2x improvement in success rate and 1.8x faster execution. Through extensive experiments and analysis, we provide insights into the effectiveness of our approach, demonstrating how it learns robust, adaptive policies for both reactive and predictive control strategies. Our results suggest that RL can indeed learn a wide range of complex vision-based manipulation policies directly in the real world within practical training times. We hope this work will inspire a new generation of learned robotic manipulation techniques, benefiting both industrial applications and research advancements. Videos and code are available at our project website https://hil-serl.github.io/.

Reinforcement learning (RL), particularly its combination with deep neural networks referred to as deep RL (DRL), has shown tremendous promise across a wide range of applications, suggesting its potential for enabling the development of sophisticated robotic behaviors. Robotics problems, however, pose fundamental difficulties for the application of RL, stemming from the complexity and cost of interacting with the physical world. This article provides a modern survey of DRL for robotics, with a particular focus on evaluating the real-world successes achieved with DRL in realizing several key robotic competencies. Our analysis aims to identify the key factors underlying those exciting successes, reveal underexplored areas, and provide an overall characterization of the status of DRL in robotics. We highlight several important avenues for future work, emphasizing the need for stable and sample-efficient real-world RL paradigms, holistic approaches for discovering and integrating various competencies to tackle complex long-horizon, open-world tasks, and principled development and evaluation procedures. This survey is designed to offer insights for both RL practitioners and roboticists toward harnessing RL's power to create generally capable real-world robotic systems.

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

Many robot manipulation videos do not indicate whether the task was successfully completed. RoboJev-27B is an open-weight vision-language model that takes a task instruction, 10 frames of a manipulation attempt, and (if available) final frames from auxiliary cameras and predicts whether the robot accomplished the task. RoboJev-27B is a variant of JEV-27B-VL, trained with a rank-32 LoRA adapter on the language model only (keeping the vision encoder frozen) using 52,598 episode records. It also uses a source-specific KL penalty that applies only to research data, anchoring predictions closer to the original model on those sources. It uses a calibrated two-token readout that outputs success/failure probabilities in a single forward pass. On 268 held-out episodes of the same robot model (SO-101), RoboJev-27B attains 95.2% balanced accuracy and 0.993 AUROC. It also generalises to episodes collected by unseen labs/robots (AUROC = 0.890 over 459 episodes) as well as to clearly labelled community-collected episodes (accuracy = 93.3% over 135 episodes), where the base model attains an AUROC = 0.900 on the unseen-lab/robot subset with the same inputs. It takes 0.26 seconds per episode (median, serial) to infer on a single H100, which is about \0.19 per 1,000 success predictions at 2.69 per GPU-hour (not including media processing and serving costs). RoboJev-27B is released together with its inference code, along with a transparent evaluation: 20,628 predictions organized into 29 model/protocol entries are made available to facilitate browsing and to enable reproducible benchmarking of success detection. We also compare against strong API-based frontier VLMs, which take in fewer input frames (4 images from the primary camera only); note that this comparison is not strictly like-for-like because RoboJev-27B is given more frames at inference.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Data-driven robotic manipulation learning depends on large-scale, high-quality expert demonstration datasets. However, existing datasets, which primarily rely on human teleoperated robot collection, are limited in terms of scalability, trajectory smoothness, and applicability across different robotic embodiments in real-world environments. In this paper, we present FastUMI-100K, a large-scale UMI-style multimodal demonstration dataset, designed to overcome these limitations and meet the growing complexity of real-world manipulation tasks. Collected by FastUMI, a novel robotic system featuring a modular, hardware-decoupled mechanical design and an integrated lightweight tracking system, FastUMI-100K offers a more scalable, flexible, and adaptable solution to fulfill the diverse requirements of real-world robot demonstration data. Specifically, FastUMI-100K contains over 100K+ demonstration trajectories collected across representative household environments, covering 54 tasks and hundreds of object types. Our dataset integrates multimodal streams, including end-effector states, multi-view wrist-mounted fisheye images and textual annotations. Each trajectory has a length ranging from 120 to 500 frames. Experimental results demonstrate that FastUMI-100K enables high policy success rates across various baseline algorithms, confirming its robustness, adaptability, and real-world applicability for solving complex, dynamic manipulation challenges. The source code and dataset will be released in this link https://github.com/MrKeee/FastUMI-100K.

Robot manipulation has seen tremendous progress in recent years, with imitation learning policies enabling successful performance of dexterous and hard-to-model tasks. Concurrently, scaling data and model size has led to the development of capable language and vision foundation models, motivating large-scale efforts to create general-purpose robot foundation models. While these models have garnered significant enthusiasm and investment, meaningful evaluation of real-world performance remains a challenge, limiting both the pace of development and inhibiting a nuanced understanding of current capabilities. In this paper, we rigorously evaluate multitask robot manipulation policies, referred to as Large Behavior Models (LBMs), by extending the Diffusion Policy paradigm across a corpus of simulated and real-world robot data. We propose and validate an evaluation pipeline to rigorously analyze the capabilities of these models with statistical confidence. We compare against single-task baselines through blind, randomized trials in a controlled setting, using both simulation and real-world experiments. We find that multi-task pretraining makes the policies more successful and robust, and enables teaching complex new tasks more quickly, using a fraction of the data when compared to single-task baselines. Moreover, performance predictably increases as pretraining scale and diversity grows. Project page: https://toyotaresearchinstitute.github.io/lbm1/

The in-vivo identification of the kidney stone types during an ureteroscopy would be a major medical advance in urology, as it could reduce the time of the tedious renal calculi extraction process, while diminishing infection risks. Furthermore, such an automated procedure would make possible to prescribe anti-recurrence treatments immediately. Nowadays, only few experienced urologists are able to recognize the kidney stone types in the images of the videos displayed on a screen during the endoscopy. Thus, several deep learning (DL) models have recently been proposed to automatically recognize the kidney stone types using ureteroscopic images. However, these DL models are of black box nature whicl limits their applicability in clinical settings. This contribution proposes a case-based reasoning DL model which uses prototypical parts (PPs) and generates local and global descriptors. The PPs encode for each class (i.e., kidney stone type) visual feature information (hue, saturation, intensity and textures) similar to that used by biologists. The PPs are optimally generated due a new loss function used during the model training. Moreover, the local and global descriptors of PPs allow to explain the decisions ("what" information, "where in the images") in an understandable way for biologists and urologists. The proposed DL model has been tested on a database including images of the six most widespread kidney stone types. The overall average classification accuracy was 90.37. When comparing this results with that of the eight other DL models of the kidney stone state-of-the-art, it can be seen that the valuable gain in explanability was not reached at the expense of accuracy which was even slightly increased with respect to that (88.2) of the best method of the literature. These promising and interpretable results also encourage urologists to put their trust in AI-based solutions.

Continuum robots are advancing bronchoscopy procedures by accessing complex lung airways and enabling targeted interventions. However, their development is limited by the lack of realistic training and test environments: Real data is difficult to collect due to ethical constraints and patient safety concerns, and developing autonomy algorithms requires realistic imaging and physical feedback. We present ROOM (Realistic Optical Observation in Medicine), a comprehensive simulation framework designed for generating photorealistic bronchoscopy training data. By leveraging patient CT scans, our pipeline renders multi-modal sensor data including RGB images with realistic noise and light specularities, metric depth maps, surface normals, optical flow and point clouds at medically relevant scales. We validate the data generated by ROOM in two canonical tasks for medical robotics -- multi-view pose estimation and monocular depth estimation, demonstrating diverse challenges that state-of-the-art methods must overcome to transfer to these medical settings. Furthermore, we show that the data produced by ROOM can be used to fine-tune existing depth estimation models to overcome these challenges, also enabling other downstream applications such as navigation. We expect that ROOM will enable large-scale data generation across diverse patient anatomies and procedural scenarios that are challenging to capture in clinical settings. Code and data: https://github.com/iamsalvatore/room.

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.

This paper presents KUKAloha, a general, low-cost, and shared-control teleoperation framework designed for construction robot arms. The proposed system employs a leader-follower paradigm in which a lightweight leading arm enables intuitive human guidance for coarse robot motion, while an autonomous perception module based on AprilTag detection performs precise alignment and grasp execution. By explicitly decoupling human control from fine manipulation, KUKAloha improves safety and repeatability when operating large-scale manipulators. We implement the framework on a KUKA robot arm and conduct a usability study with representative construction manipulation tasks. Experimental results demonstrate that KUKAloha reduces operator workload, improves task completion efficiency, and provides a practical solution for scalable demonstration collection and shared human-robot control in construction environments.

The construction industry has long explored robotics and computer vision, yet their deployment on construction sites remains very limited. These technologies have the potential to revolutionize traditional workflows by enhancing accuracy, efficiency, and safety in construction management. Ground robots equipped with advanced vision systems could automate tasks such as monitoring mechanical, electrical, and plumbing (MEP) systems. The present research evaluates the applicability of open-vocabulary vision-language models compared to fine-tuned, lightweight, closed-set object detectors for detecting MEP components using a mobile ground robotic platform. A dataset collected with cameras mounted on a ground robot was manually annotated and analyzed to compare model performance. The results demonstrate that, despite the versatility of vision-language models, fine-tuned lightweight models still largely outperform them in specialized environments and for domain-specific tasks.

The pre-training of visual representations has enhanced the efficiency of robot learning. Due to the lack of large-scale in-domain robotic datasets, prior works utilize in-the-wild human videos to pre-train robotic visual representation. Despite their promising results, representations from human videos are inevitably subject to distribution shifts and lack the dynamics information crucial for task completion. We first evaluate various pre-trained representations in terms of their correlation to the downstream robotic manipulation tasks (i.e., manipulation centricity). Interestingly, we find that the "manipulation centricity" is a strong indicator of success rates when applied to downstream tasks. Drawing from these findings, we propose Manipulation Centric Representation (MCR), a foundation representation learning framework capturing both visual features and the dynamics information such as actions and proprioceptions of manipulation tasks to improve manipulation centricity. Specifically, we pre-train a visual encoder on the DROID robotic dataset and leverage motion-relevant data such as robot proprioceptive states and actions. We introduce a novel contrastive loss that aligns visual observations with the robot's proprioceptive state-action dynamics, combined with a behavior cloning (BC)-like actor loss to predict actions during pre-training, along with a time contrastive loss. Empirical results across 4 simulation domains with 20 tasks verify that MCR outperforms the strongest baseline method by 14.8%. Moreover, MCR boosts the performance of data-efficient learning with a UR5e arm on 3 real-world tasks by 76.9%. Project website: https://robots-pretrain-robots.github.io/.

Osteoarthritis (OA) is the most common musculoskeletal disease, which has no cure. Knee OA (KOA) is one of the highest causes of disability worldwide, and it costs billions of United States dollars to the global community. Prediction of KOA progression has been of high interest to the community for years, as it can advance treatment development through more efficient clinical trials and improve patient outcomes through more efficient healthcare utilization. Existing approaches for predicting KOA, however, are predominantly static, i.e. consider data from a single time point to predict progression many years into the future, and knee level, i.e. consider progression in a single joint only. Due to these and related reasons, these methods fail to deliver the level of predictive performance, which is sufficient to result in cost savings and better patient outcomes. Collecting extensive data from all patients on a regular basis could address the issue, but it is limited by the high cost at a population level. In this work, we propose to go beyond static prediction models in OA, and bring a novel Active Sensing (AS) approach, designed to dynamically follow up patients with the objective of maximizing the number of informative data acquisitions, while minimizing their total cost over a period of time. Our approach is based on Reinforcement Learning (RL), and it leverages a novel reward function designed specifically for AS of disease progression in more than one part of a human body. Our method is end-to-end, relies on multi-modal Deep Learning, and requires no human input at inference time. Throughout an exhaustive experimental evaluation, we show that using RL can provide a higher monetary benefit when compared to state-of-the-art baselines.