arXiv subjects

Mengya Xu

Publications and source records attributed to Mengya Xu.

At least 19 recordsLinked to original sources

arXiv2026

SurgAM: Surgical Affordance Map Prediction with Multimodal Feature Fusion for Robot Autonomy

Surgical automation is being increasingly studied, yet bridging visual scene understanding with autonomous action planning remains a fundamental challenge. While much research effort has been made on scene perception (e.g., tool recognition and scene segmentation), understanding and predicting actionable possibilities for surgical automation is still underexplored. In this paper, we introduce surgical affordance prediction, which identifies actionable regions for fundamental surgical actions from visual data. Specifically, a novel adaptive feature fusion framework is proposed that leverages the complementary strengths of a self-supervised vision transformer encoder for its superior semantic understanding and a large-scale generative model encoder for its spatially-aware capability. Furthermore, we introduce a hierarchical prompt learning mechanism to adapt to varying procedural contexts. Finally, a scene-guided attention decoder is proposed to focus on critical surgical areas while suppressing background distractions. To validate the effectiveness, we established a new dataset, derived from publicly available surgical datasets with affordance annotations for three basic surgical actions: aspiration, clipping, and retraction. Extensive experiments demonstrate that our approach achieves state-of-the-art performance. Moreover, we validate our framework's applicability for downstream automation on a realistic lung and prostate phantom, and results show that the predicted affordance maps successfully enable autonomous surgical actions.

cs.RO↗

arXiv2026

SurfSurg6D: Geometry Consistent Dense Correspondence for Textureless Surgical Instrument Pose Estimation

Surgical instrument pose estimation provides crucial information for promising applications, including autonomous robotic surgery, skill assessment, and standardization of surgical workflow. However, this task remains highly challenging due to high precision requirements, frequent occlusions, textureless instruments, scarcity of depth information and very limited annotated data. These constraints often lead to unsatisfactory performance when employing general object pose estimation approaches to surgical scenarios. To address these issues, we first construct a new dataset SynSurg6D, to alleviate the data shortage in this task. We further propose SurfSurg6D, a dense-correspondence framework tailored for surgical instrument pose estimation. Experimental results on the SurgRIPE, EndoVis2018 and SurgPose datasets demonstrate that the introduction of our generated dataset SynSurg6D is able to diversify the pose distributions, thus enhancing the performance of existing approaches. Furthermore, SurfSurg6D outperforms existing methods, providing a robust solution for precise and efficient RGB-only pose estimation.

cs.CV↗

arXiv2026

Intuitive Surgical SurgToolLoc and SurgVU Challenges Results: 2022-2025

Robotic assisted (RA) surgery promises to transform surgical intervention. Intuitive Surgical is committed to fostering these changes and the machine learning models and algorithms that will enable them. With these goals in mind we have invited the surgical data science community to participate in a yearly competition hosted through the Medical Imaging Computing and Computer Assisted Interventions (MICCAI) conference. With varying changes from year to year, we have challenged the community to solve difficult machine learning problems in the context of advanced RA applications. Here we document the results of these challenges, focusing on surgical tool localization (SurgToolLoc) and surgical visual understanding (SurgVU). The publicly released dataset that accompanies these challenges is detailed in a separate paper arXiv:2501.09209 [1].

cs.CV↗

arXiv2026

Surg$Σ$: A Spectrum of Large-Scale Multimodal Data and Foundation Models for Surgical Intelligence

Surgical intelligence has the potential to improve the safety and consistency of surgical care, yet most existing surgical AI frameworks remain task-specific and struggle to generalize across procedures and institutions. Although multimodal foundation models, particularly multimodal large language models, have demonstrated strong cross-task capabilities across various medical domains, their advancement in surgery remains constrained by the lack of large-scale, systematically curated multimodal data. To address this challenge, we introduce Surg$Σ$, a spectrum of large-scale multimodal data and foundation models for surgical intelligence. At the core of this framework lies Surg$Σ$-DB, a large-scale multimodal data foundation designed to support diverse surgical tasks. Surg$Σ$-DB consolidates heterogeneous surgical data sources (including open-source datasets, curated in-house clinical collections and web-source data) into a unified schema, aiming to improve label consistency and data standardization across heterogeneous datasets. Surg$Σ$-DB spans 6 clinical specialties and diverse surgical types, providing rich image- and video-level annotations across 18 practical surgical tasks covering understanding, reasoning, planning, and generation, at an unprecedented scale (over 5.98M conversations). Beyond conventional multimodal conversations, Surg$Σ$-DB incorporates hierarchical reasoning annotations, providing richer semantic cues to support deeper contextual understanding in complex surgical scenarios. We further provide empirical evidence through recently developed surgical foundation models built upon Surg$Σ$-DB, illustrating the practical benefits of large-scale multimodal annotations, unified semantic design, and structured reasoning annotations for improving cross-task generalization and interpretability.

cs.AI↗

arXiv2026

Generalized Recognition of Basic Surgical Actions Enables Skill Assessment and Vision-Language-Model-based Surgical Planning

Artificial intelligence, imaging, and large language models have the potential to transform surgical practice, training, and automation. Understanding and modeling of basic surgical actions (BSA), the fundamental unit of operation in any surgery, is important to drive the evolution of this field. In this paper, we present a BSA dataset comprising 10 basic actions across 6 surgical specialties with over 11,000 video clips, which is the largest to date. Based on the BSA dataset, we developed a new foundation model that conducts general-purpose recognition of basic actions. Our approach demonstrates robust cross-specialist performance in experiments validated on datasets from different procedural types and various body parts. Furthermore, we demonstrate downstream applications enabled by the BAS foundation model through surgical skill assessment in prostatectomy using domain-specific knowledge, and action planning in cholecystectomy and nephrectomy using large vision-language models. Multinational surgeons' evaluation of the language model's output of the action planning explainable texts demonstrated clinical relevance. These findings indicate that basic surgical actions can be robustly recognized across scenarios, and an accurate BSA understanding model can essentially facilitate complex applications and speed up the realization of surgical superintelligence.

cs.CV↗

arXiv2026

Cosmos-H-Surgical: Learning Surgical Robot Policies from Videos via World Modeling

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 Cosmos-H-Surgical, 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 Cosmos-H-Surgical 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.

cs.RO↗

arXiv2026

Comparative validation of surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation in endoscopy: Results of the PhaKIR 2024 challenge

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.

cs.CV↗

arXiv2025

EndoControlMag: Robust Endoscopic Vascular Motion Magnification with Periodic Reference Resetting and Hierarchical Tissue-aware Dual-Mask Control

Visualizing subtle vascular motions in endoscopic surgery is crucial for surgical precision and decision-making, yet remains challenging due to the complex and dynamic nature of surgical scenes. To address this, we introduce EndoControlMag, a training-free, Lagrangian-based framework with mask-conditioned vascular motion magnification tailored to endoscopic environments. Our approach features two key modules: a Periodic Reference Resetting (PRR) scheme that divides videos into short overlapping clips with dynamically updated reference frames to prevent error accumulation while maintaining temporal coherence, and a Hierarchical Tissue-aware Magnification (HTM) framework with dual-mode mask dilation. HTM first tracks vessel cores using a pretrained visual tracking model to maintain accurate localization despite occlusions and view changes. It then applies one of two adaptive softening strategies to surrounding tissues: motion-based softening that modulates magnification strength proportional to observed tissue displacement, or distance-based exponential decay that simulates biomechanical force attenuation. This dual-mode approach accommodates diverse surgical scenarios-motion-based softening excels with complex tissue deformations while distance-based softening provides stability during unreliable optical flow conditions. We evaluate EndoControlMag on our EndoVMM24 dataset spanning four different surgery types and various challenging scenarios, including occlusions, instrument disturbance, view changes, and vessel deformations. Quantitative metrics, visual assessments, and expert surgeon evaluations demonstrate that EndoControlMag significantly outperforms existing methods in both magnification accuracy and visual quality while maintaining robustness across challenging surgical conditions. The code, dataset, and video results are available at https://szupc.github.io/EndoControlMag/.

eess.IV↗

arXiv2025

BleedOrigin: Dynamic Bleeding Source Localization in Endoscopic Submucosal Dissection via Dual-Stage Detection and Tracking

Intraoperative bleeding during Endoscopic Submucosal Dissection (ESD) poses significant risks, demanding precise, real-time localization and continuous monitoring of the bleeding source for effective hemostatic intervention. In particular, endoscopists have to repeatedly flush to clear blood, allowing only milliseconds to identify bleeding sources, an inefficient process that prolongs operations and elevates patient risks. However, current Artificial Intelligence (AI) methods primarily focus on bleeding region segmentation, overlooking the critical need for accurate bleeding source detection and temporal tracking in the challenging ESD environment, which is marked by frequent visual obstructions and dynamic scene changes. This gap is widened by the lack of specialized datasets, hindering the development of robust AI-assisted guidance systems. To address these challenges, we introduce BleedOrigin-Bench, the first comprehensive ESD bleeding source dataset, featuring 1,771 expert-annotated bleeding sources across 106,222 frames from 44 procedures, supplemented with 39,755 pseudo-labeled frames. This benchmark covers 8 anatomical sites and 6 challenging clinical scenarios. We also present BleedOrigin-Net, a novel dual-stage detection-tracking framework for the bleeding source localization in ESD procedures, addressing the complete workflow from bleeding onset detection to continuous spatial tracking. We compare with widely-used object detection models (YOLOv11/v12), multimodal large language models, and point tracking methods. Extensive evaluation demonstrates state-of-the-art performance, achieving 96.85% frame-level accuracy ($\pm\leq8$ frames) for bleeding onset detection, 70.24% pixel-level accuracy ($\leq100$ px) for initial source detection, and 96.11% pixel-level accuracy ($\leq100$ px) for point tracking.

cs.CV↗

arXiv2025

SAP-Bench: Benchmarking Multimodal Large Language Models in Surgical Action Planning

Effective evaluation is critical for driving advancements in MLLM research. The surgical action planning (SAP) task, which aims to generate future action sequences from visual inputs, demands precise and sophisticated analytical capabilities. Unlike mathematical reasoning, surgical decision-making operates in life-critical domains and requires meticulous, verifiable processes to ensure reliability and patient safety. This task demands the ability to distinguish between atomic visual actions and coordinate complex, long-horizon procedures, capabilities that are inadequately evaluated by current benchmarks. To address this gap, we introduce SAP-Bench, a large-scale, high-quality dataset designed to enable multimodal large language models (MLLMs) to perform interpretable surgical action planning. Our SAP-Bench benchmark, derived from the cholecystectomy procedures context with the mean duration of 1137.5s, and introduces temporally-grounded surgical action annotations, comprising the 1,226 clinically validated action clips (mean duration: 68.7s) capturing five fundamental surgical actions across 74 procedures. The dataset provides 1,152 strategically sampled current frames, each paired with the corresponding next action as multimodal analysis anchors. We propose the MLLM-SAP framework that leverages MLLMs to generate next action recommendations from the current surgical scene and natural language instructions, enhanced with injected surgical domain knowledge. To assess our dataset's effectiveness and the broader capabilities of current models, we evaluate seven state-of-the-art MLLMs (e.g., OpenAI-o1, GPT-4o, QwenVL2.5-72B, Claude-3.5-Sonnet, GeminiPro2.5, Step-1o, and GLM-4v) and reveal critical gaps in next action prediction performance.

cs.CV↗

arXiv2025

EndoARSS: Adapting Spatially-Aware Foundation Model for Efficient Activity Recognition and Semantic Segmentation in Endoscopic Surgery

Endoscopic surgery is the gold standard for robotic-assisted minimally invasive surgery, offering significant advantages in early disease detection and precise interventions. However, the complexity of surgical scenes, characterized by high variability in different surgical activity scenarios and confused image features between targets and the background, presents challenges for surgical environment understanding. Traditional deep learning models often struggle with cross-activity interference, leading to suboptimal performance in each downstream task. To address this limitation, we explore multi-task learning, which utilizes the interrelated features between tasks to enhance overall task performance. In this paper, we propose EndoARSS, a novel multi-task learning framework specifically designed for endoscopy surgery activity recognition and semantic segmentation. Built upon the DINOv2 foundation model, our approach integrates Low-Rank Adaptation to facilitate efficient fine-tuning while incorporating Task Efficient Shared Low-Rank Adapters to mitigate gradient conflicts across diverse tasks. Additionally, we introduce the Spatially-Aware Multi-Scale Attention that enhances feature representation discrimination by enabling cross-spatial learning of global information. In order to evaluate the effectiveness of our framework, we present three novel datasets, MTLESD, MTLEndovis and MTLEndovis-Gen, tailored for endoscopic surgery scenarios with detailed annotations for both activity recognition and semantic segmentation tasks. Extensive experiments demonstrate that EndoARSS achieves remarkable performance across multiple benchmarks, significantly improving both accuracy and robustness in comparison to existing models. These results underscore the potential of EndoARSS to advance AI-driven endoscopic surgical systems, offering valuable insights for enhancing surgical safety and efficiency.

cs.CV↗

arXiv2025

Surgical Action Planning with Large Language Models

In robot-assisted minimally invasive surgery, we introduce the Surgical Action Planning (SAP) task, which generates future action plans from visual inputs to address the absence of intraoperative predictive planning in current intelligent applications. SAP shows great potential for enhancing intraoperative guidance and automating procedures. However, it faces challenges such as understanding instrument-action relationships and tracking surgical progress. Large Language Models (LLMs) show promise in understanding surgical video content but remain underexplored for predictive decision-making in SAP, as they focus mainly on retrospective analysis. Challenges like data privacy, computational demands, and modality-specific constraints further highlight significant research gaps. To tackle these challenges, we introduce LLM-SAP, a Large Language Models-based Surgical Action Planning framework that predicts future actions and generates text responses by interpreting natural language prompts of surgical goals. The text responses potentially support surgical education, intraoperative decision-making, procedure documentation, and skill analysis. LLM-SAP integrates two novel modules: the Near-History Focus Memory Module (NHF-MM) for modeling historical states and the prompts factory for action planning. We evaluate LLM-SAP on our constructed CholecT50-SAP dataset using models like Qwen2.5 and Qwen2-VL, demonstrating its effectiveness in next-action prediction. Pre-trained LLMs are tested in a zero-shot setting, and supervised fine-tuning (SFT) with LoRA is implemented. Our experiments show that Qwen2.5-72B-SFT surpasses Qwen2.5-72B with a 19.3% higher accuracy.

cs.CL↗

arXiv2024

ETSM: Automating Dissection Trajectory Suggestion and Confidence Map-Based Safety Margin Prediction for Robot-assisted Endoscopic Submucosal Dissection

Robot-assisted Endoscopic Submucosal Dissection (ESD) improves the surgical procedure by providing a more comprehensive view through advanced robotic instruments and bimanual operation, thereby enhancing dissection efficiency and accuracy. Accurate prediction of dissection trajectories is crucial for better decision-making, reducing intraoperative errors, and improving surgical training. Nevertheless, predicting these trajectories is challenging due to variable tumor margins and dynamic visual conditions. To address this issue, we create the ESD Trajectory and Confidence Map-based Safety Margin (ETSM) dataset with $1849$ short clips, focusing on submucosal dissection with a dual-arm robotic system. We also introduce a framework that combines optimal dissection trajectory prediction with a confidence map-based safety margin, providing a more secure and intelligent decision-making tool to minimize surgical risks for ESD procedures. Additionally, we propose the Regression-based Confidence Map Prediction Network (RCMNet), which utilizes a regression approach to predict confidence maps for dissection areas, thereby delineating various levels of safety margins. We evaluate our RCMNet using three distinct experimental setups: in-domain evaluation, robustness assessment, and out-of-domain evaluation. Experimental results show that our approach excels in the confidence map-based safety margin prediction task, achieving a mean absolute error (MAE) of only $3.18$. To the best of our knowledge, this is the first study to apply a regression approach for visual guidance concerning delineating varying safety levels of dissection areas. Our approach bridges gaps in current research by improving prediction accuracy and enhancing the safety of the dissection process, showing great clinical significance in practice.

cs.RO↗

arXiv2024

PDZSeg: Adapting the Foundation Model for Dissection Zone Segmentation with Visual Prompts in Robot-assisted Endoscopic Submucosal Dissection

Purpose: Endoscopic surgical environments present challenges for dissection zone segmentation due to unclear boundaries between tissue types, leading to segmentation errors where models misidentify or overlook edges. This study aims to provide precise dissection zone suggestions during endoscopic submucosal dissection (ESD) procedures, enhancing ESD safety. Methods: We propose the Prompted-based Dissection Zone Segmentation (PDZSeg) model, designed to leverage diverse visual prompts such as scribbles and bounding boxes. By overlaying these prompts onto images and fine-tuning a foundational model on a specialized dataset, our approach improves segmentation performance and user experience through flexible input methods. Results: The PDZSeg model was validated using three experimental setups: in-domain evaluation, variability in visual prompt availability, and robustness assessment. Using the ESD-DZSeg dataset, results show that our method outperforms state-of-the-art segmentation approaches. This is the first study to integrate visual prompt design into dissection zone segmentation. Conclusion: The PDZSeg model effectively utilizes visual prompts to enhance segmentation performance and user experience, supported by the novel ESD-DZSeg dataset as a benchmark for dissection zone segmentation in ESD. Our work establishes a foundation for future research.

cs.CV↗

arXiv2024

Benchmarking Robustness of Endoscopic Depth Estimation with Synthetically Corrupted Data

Accurate depth perception is crucial for patient outcomes in endoscopic surgery, yet it is compromised by image distortions common in surgical settings. To tackle this issue, our study presents a benchmark for assessing the robustness of endoscopic depth estimation models. We have compiled a comprehensive dataset that reflects real-world conditions, incorporating a range of synthetically induced corruptions at varying severity levels. To further this effort, we introduce the Depth Estimation Robustness Score (DERS), a novel metric that combines measures of error, accuracy, and robustness to meet the multifaceted requirements of surgical applications. This metric acts as a foundational element for evaluating performance, establishing a new paradigm for the comparative analysis of depth estimation technologies. Additionally, we set forth a benchmark focused on robustness for the evaluation of depth estimation in endoscopic surgery, with the aim of driving progress in model refinement. A thorough analysis of two monocular depth estimation models using our framework reveals crucial information about their reliability under adverse conditions. Our results emphasize the essential need for algorithms that can tolerate data corruption, thereby advancing discussions on improving model robustness. The impact of this research transcends theoretical frameworks, providing concrete gains in surgical precision and patient safety. This study establishes a benchmark for the robustness of depth estimation and serves as a foundation for developing more resilient surgical support technologies. Code is available at https://github.com/lofrienger/EndoDepthBenchmark.

cs.CV↗

arXiv2024

A Review of 3D Reconstruction Techniques for Deformable Tissues in Robotic Surgery

As a crucial and intricate task in robotic minimally invasive surgery, reconstructing surgical scenes using stereo or monocular endoscopic video holds immense potential for clinical applications. NeRF-based techniques have recently garnered attention for the ability to reconstruct scenes implicitly. On the other hand, Gaussian splatting-based 3D-GS represents scenes explicitly using 3D Gaussians and projects them onto a 2D plane as a replacement for the complex volume rendering in NeRF. However, these methods face challenges regarding surgical scene reconstruction, such as slow inference, dynamic scenes, and surgical tool occlusion. This work explores and reviews state-of-the-art (SOTA) approaches, discussing their innovations and implementation principles. Furthermore, we replicate the models and conduct testing and evaluation on two datasets. The test results demonstrate that with advancements in these techniques, achieving real-time, high-quality reconstructions becomes feasible.

cs.CV↗

arXiv2024

SAM 2 in Robotic Surgery: An Empirical Evaluation for Robustness and Generalization in Surgical Video Segmentation

The recent Segment Anything Model (SAM) 2 has demonstrated remarkable foundational competence in semantic segmentation, with its memory mechanism and mask decoder further addressing challenges in video tracking and object occlusion, thereby achieving superior results in interactive segmentation for both images and videos. Building upon our previous empirical studies, we further explore the zero-shot segmentation performance of SAM 2 in robot-assisted surgery based on prompts, alongside its robustness against real-world corruption. For static images, we employ two forms of prompts: 1-point and bounding box, while for video sequences, the 1-point prompt is applied to the initial frame. Through extensive experimentation on the MICCAI EndoVis 2017 and EndoVis 2018 benchmarks, SAM 2, when utilizing bounding box prompts, outperforms state-of-the-art (SOTA) methods in comparative evaluations. The results with point prompts also exhibit a substantial enhancement over SAM's capabilities, nearing or even surpassing existing unprompted SOTA methodologies. Besides, SAM 2 demonstrates improved inference speed and less performance degradation against various image corruption. Although slightly unsatisfactory results remain in specific edges or regions, SAM 2's robust adaptability to 1-point prompts underscores its potential for downstream surgical tasks with limited prompt requirements.

cs.CV↗

arXiv2024

PitVQA: Image-grounded Text Embedding LLM for Visual Question Answering in Pituitary Surgery

Visual Question Answering (VQA) within the surgical domain, utilizing Large Language Models (LLMs), offers a distinct opportunity to improve intra-operative decision-making and facilitate intuitive surgeon-AI interaction. However, the development of LLMs for surgical VQA is hindered by the scarcity of diverse and extensive datasets with complex reasoning tasks. Moreover, contextual fusion of the image and text modalities remains an open research challenge due to the inherent differences between these two types of information and the complexity involved in aligning them. This paper introduces PitVQA, a novel dataset specifically designed for VQA in endonasal pituitary surgery and PitVQA-Net, an adaptation of the GPT2 with a novel image-grounded text embedding for surgical VQA. PitVQA comprises 25 procedural videos and a rich collection of question-answer pairs spanning crucial surgical aspects such as phase and step recognition, context understanding, tool detection and localization, and tool-tissue interactions. PitVQA-Net consists of a novel image-grounded text embedding that projects image and text features into a shared embedding space and GPT2 Backbone with an excitation block classification head to generate contextually relevant answers within the complex domain of endonasal pituitary surgery. Our image-grounded text embedding leverages joint embedding, cross-attention and contextual representation to understand the contextual relationship between questions and surgical images. We demonstrate the effectiveness of PitVQA-Net on both the PitVQA and the publicly available EndoVis18-VQA dataset, achieving improvements in balanced accuracy of 8% and 9% over the most recent baselines, respectively. Our code and dataset is available at https://github.com/mobarakol/PitVQA.

cs.CV↗