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May 15

SurgTEMP: Temporal-Aware Surgical Video Question Answering with Text-guided Visual Memory for Laparoscopic Cholecystectomy

Surgical procedures are inherently complex and risky, requiring extensive expertise and constant focus to navigate evolving intraoperative scenes. Computer-assisted systems such as surgical visual question answering (VQA) offer promises for education and intraoperative support. Current surgical VQA research largely focuses on static frame analysis, overlooking rich temporal semantics. Surgical video question answering is further challenged by low visual contrast, its highly knowledge-driven nature, diverse analytical needs spanning scattered temporal windows, and the hierarchy from basic perception to high-level intraoperative assessment. To address these challenges, we propose SurgTEMP, a multimodal LLM framework featuring (i) a query-guided token selection module that builds hierarchical visual memory (spatial and temporal memory banks) and (ii) a Surgical Competency Progression (SCP) training scheme. Together, they enable effective modeling of variable-length surgical videos while preserving procedure-relevant cues and temporal coherence, and better support diverse downstream assessment tasks. To support model development, we introduce CholeVidQA-32K, a surgical video question answering dataset comprising 32K open-ended QA pairs and 3,855 video segments (approximately 128 h total) from laparoscopic cholecystectomy. The dataset is organized into a three-level hierarchy -- Perception, Assessment, and Reasoning -- spanning 11 tasks from instrument/action/anatomy perception to Critical View of Safety (CVS), intraoperative difficulty, skill proficiency, and adverse event assessment. In comprehensive evaluations against state-of-the-art open-source multimodal and video LLMs (fine-tuned and zero-shot), SurgTEMP achieves substantial performance improvements, advancing the state of video-based surgical VQA. The project page is available at: https://camma-public.github.io/SurgTEMP/

  • 9 authors
·
May 3

Enhanced Scale-aware Depth Estimation for Monocular Endoscopic Scenes with Geometric Modeling

Scale-aware monocular depth estimation poses a significant challenge in computer-aided endoscopic navigation. However, existing depth estimation methods that do not consider the geometric priors struggle to learn the absolute scale from training with monocular endoscopic sequences. Additionally, conventional methods face difficulties in accurately estimating details on tissue and instruments boundaries. In this paper, we tackle these problems by proposing a novel enhanced scale-aware framework that only uses monocular images with geometric modeling for depth estimation. Specifically, we first propose a multi-resolution depth fusion strategy to enhance the quality of monocular depth estimation. To recover the precise scale between relative depth and real-world values, we further calculate the 3D poses of instruments in the endoscopic scenes by algebraic geometry based on the image-only geometric primitives (i.e., boundaries and tip of instruments). Afterwards, the 3D poses of surgical instruments enable the scale recovery of relative depth maps. By coupling scale factors and relative depth estimation, the scale-aware depth of the monocular endoscopic scenes can be estimated. We evaluate the pipeline on in-house endoscopic surgery videos and simulated data. The results demonstrate that our method can learn the absolute scale with geometric modeling and accurately estimate scale-aware depth for monocular scenes.

  • 6 authors
·
Aug 13, 2024

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.

  • 61 authors
·
Jan 18

SurgRAW: Multi-Agent Workflow with Chain-of-Thought Reasoning for Surgical Intelligence

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.

  • 7 authors
·
Mar 13, 2025

Instrumental Choices: Measuring the Propensity of LLM Agents to Pursue Instrumental Behaviors

AI systems have become increasingly capable of dangerous behaviours in many domains. This raises the question: Do models sometimes choose to violate human instructions in order to perform behaviour that is more useful for certain goals? We introduce a benchmark for measuring model propensity for instrumental convergence (IC) behaviour in terminal-based agents. This is behaviour such as self-preservation that has been hypothesised to play a key role in risks from highly capable AI agents. Our benchmark is realistic and low-stakes which serves to reduce evaluation-awareness and roleplay confounds. The suite contains seven operational tasks, each with an official workflow and a policy-violating shortcut. An eight-variant shared framework varies monitoring, instruction clarity, stakes, permission, instrumental usefulness and blocked honest paths to support inferences regarding the factors driving IC behaviour. We evaluated ten models using deterministic environment-state scorers over 1,680 samples, with trace review employed for audit and adjudication purposes. The final IC rate is 86 out of 1,680 samples (5.1%). IC behaviour is concentrated rather than uniform: two Gemini models account for 66.3% of IC cases and three tasks account for 84.9%. Conditions in which IC behaviour is indispensable for task success result in the greatest increase in the adjusted IC rate (+15.7 percentage points), whereas emphasising that task success is critical or certain framing choices do not produce comparable effects. Our findings indicate that realistic, low-nudge environments elicit IC behaviour rarely but systematically in most tested models. We conclude that it is feasible to robustly measure tendencies for dangerous behaviour in current frontier AI agents.

  • 3 authors
·
May 6

MuSE-SVS: Multi-Singer Emotional Singing Voice Synthesizer that Controls Emotional Intensity

We propose a multi-singer emotional singing voice synthesizer, Muse-SVS, that expresses emotion at various intensity levels by controlling subtle changes in pitch, energy, and phoneme duration while accurately following the score. To control multiple style attributes while avoiding loss of fidelity and expressiveness due to interference between attributes, Muse-SVS represents all attributes and their relations together by a joint embedding in a unified embedding space. Muse-SVS can express emotional intensity levels not included in the training data through embedding interpolation and extrapolation. We also propose a statistical pitch predictor to express pitch variance according to emotional intensity, and a context-aware residual duration predictor to prevent the accumulation of variances in phoneme duration, which is crucial for synchronization with instrumental parts. In addition, we propose a novel ASPP-Transformer, which combines atrous spatial pyramid pooling (ASPP) and Transformer, to improve fidelity and expressiveness by referring to broad contexts. In experiments, Muse-SVS exhibited improved fidelity, expressiveness, and synchronization performance compared with baseline models. The visualization results show that Muse-SVS effectively express the variance in pitch, energy, and phoneme duration according to emotional intensity. To the best of our knowledge, Muse-SVS is the first neural SVS capable of controlling emotional intensity.