Open-H-Embodiment: A Large-Scale Dataset for Enabling Foundation Models in Medical Robotics

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.

LAR-MoE: Latent-Aligned Routing for Mixture of Experts in Robotic Imitation Learning

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.

MoE-ACT: Improving Surgical Imitation Learning Policies through Supervised Mixture-of-Experts

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.