MedVLA: A Hierarchical Vision-Language-Action Framework for Closed-Loop Precision Medical Robot Manipulation

Abstract

Precision medical robotics demands adaptive decision-making under strict safety, interpretability, and execution constraints. Although recent Vision-Language-Action (VLA) models show strong multimodal reasoning ability, their continuous action generation paradigm is not well suited for precision medical tasks, where reliable closed-loop operation may also depend on non-action system function calls. To address this gap, we propose MedVLA, a hierarchical framework that couples high-level multimodal reasoning with low-level function-constrained execution. We further introduce a scalable multi-agent pipeline to generate skill-oriented chain-of-thought(CoT) data for structured training. Built on different multimodal large-model backbones, MedVLA consistently improves performance after fine-tuning, demonstrating the effectiveness of the proposed framework across model variants. Under identical initial conditions, we perform 100 closed-loop flexible electrode implantation trials. The results show that MedVLA achieves a 95.0\% task success rate, substantially outperforming representative VLA baselines, including OpenVLA (8\%) and $π_0$ (15\%), in accuracy, stability, and safety. These results indicate that structured reasoning with constrained function-level execution is a practical route toward deployable precision medical robotics.