for the ALFA study
Abstract:Vision foundation models are bottlenecked by the quadratic cost of self-attention, which limits usable resolution and increases the cost of large-scale pretraining. Subquadratic alternatives such as linear attention and state-space models reduce this cost, but often serialize images into 1D token streams and weaken the 2D spatial structure important for vision. Generalized Spatial Propagation Networks (GSPN) instead propagate context directly on the 2D grid through line-scan recurrences, achieving near-linear complexity without positional embeddings, but have seen little use as foundation-scale encoders. We present C-GSPN, a foundation-scale vision encoder based on 2D spatial propagation. C-GSPN makes the operator practical through three improvements: (1) a fast GSPN CUDA kernel that fuses per-step launches into a single warp-specialized implementation with shared-memory tiling, coalesced access, and a compact multi-channel propagation, reaching over 90% of peak memory bandwidth and running up to 40--52x faster than the original GSPN implementation; (2) a compressed latent-space propagation block with fused normalization, which turns kernel-level speed into block- and model-level efficiency; and (3) a two-stage cross-operator distillation recipe that trains the new architecture from an attention teacher without the cost of from-scratch foundation-scale training. Distilled with 600M image-text pairs, C-GSPN matches an isomorphic ViT baseline with 15% fewer parameters, improves ADE20K segmentation by +2.1%, transfers to high resolution with a fraction of the data needed from scratch, and delivers a 4x end-to-end block speedup at 2K with single-pass, tiling-free inference.
Abstract:Monocular 3D shape recovery is fundamental to geometric understanding, yet achieving robust generalization across arbitrary viewpoints and unseen object categories remains a significant challenge. In this paper, we present a generalizable deformation learning framework that reconstructs 3D objects by explicitly deforming a category-level shape template to match the target observation. To address complex shape variations between the template and the target, we introduce a geometry-guided feature modeling mechanism. This process first enriches foundation features with template topology to yield a geometry-aware representation, which is then explicitly correlated with the target observation to guide precise deformation. Furthermore, to bridge the disparity between the fixed template and arbitrary target views, we propose a view-adaptive feature aggregation module. This module leverages multi-view template features and their corresponding camera poses to enrich the canonical template representation, ensuring robust feature alignment regardless of the target's perspective. Extensive experiments demonstrate that our approach significantly outperforms state-of-the-art methods in handling large shape variations and diverse viewpoints, exhibiting strong generalization to novel categories and effectively supporting downstream real-world dexterous robotic manipulation tasks. Project homepage: https://GODeform.github.io/
Abstract: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.
Abstract:Vision-language models (VLMs) have achieved remarkable success across diverse tasks. However, concerns about their trustworthiness persist, particularly regarding tendencies to lean more on textual cues than visual evidence and the risk of producing ungrounded or fabricated responses. To address these issues, we propose Saliency-R1, a framework for improving the interpretability and faithfulness of VLMs reasoning. Specifically, we introduce a novel saliency map technique that efficiently highlights critical image regions contributing to generated tokens without additional computational overhead. This can further be extended to trace how visual information flows through the reasoning process to the final answers, revealing the alignment between the thinking process and the visual context. We use the overlap between the saliency maps and human-annotated bounding boxes as the reward function, and apply Group Relative Policy Optimization (GRPO) to align the salient parts and critical regions, encouraging models to focus on relevant areas when conduct reasoning. Experiments show Saliency-R1 improves reasoning faithfulness, interpretability, and overall task performance.
Abstract: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.
Abstract: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.
Abstract:Surgical scene understanding demands not only accurate predictions but also interpretable reasoning that surgeons can verify against clinical expertise. However, existing surgical vision-language models generate predictions without reasoning chains, and general-purpose reasoning models fail on compositional surgical tasks without domain-specific knowledge. We present Surg-R1, a surgical Vision-Language Model that addresses this gap through hierarchical reasoning trained via a four-stage pipeline. Our approach introduces three key contributions: (1) a three-level reasoning hierarchy decomposing surgical interpretation into perceptual grounding, relational understanding, and contextual reasoning; (2) the largest surgical chain-of-thought dataset with 320,000 reasoning pairs; and (3) a four-stage training pipeline progressing from supervised fine-tuning to group relative policy optimization and iterative self-improvement. Evaluation on SurgBench, comprising six public benchmarks and six multi-center external validation datasets from five institutions, demonstrates that Surg-R1 achieves the highest Arena Score (64.9%) on public benchmarks versus Gemini 3.0 Pro (46.1%) and GPT-5.1 (37.9%), outperforming both proprietary reasoning models and specialized surgical VLMs on the majority of tasks spanning instrument localization, triplet recognition, phase recognition, action recognition, and critical view of safety assessment, with a 15.2 percentage point improvement over the strongest surgical baseline on external validation.
Abstract:Generating high-quality 360° panoramic videos from perspective input is one of the crucial applications for virtual reality (VR), whereby high-resolution videos are especially important for immersive experience. Existing methods are constrained by computational limitations of vanilla diffusion models, only supporting $\leq$ 1K resolution native generation and relying on suboptimal post super-resolution to increase resolution. We introduce CubeComposer, a novel spatio-temporal autoregressive diffusion model that natively generates 4K-resolution 360° videos. By decomposing videos into cubemap representations with six faces, CubeComposer autoregressively synthesizes content in a well-planned spatio-temporal order, reducing memory demands while enabling high-resolution output. Specifically, to address challenges in multi-dimensional autoregression, we propose: (1) a spatio-temporal autoregressive strategy that orchestrates 360° video generation across cube faces and time windows for coherent synthesis; (2) a cube face context management mechanism, equipped with a sparse context attention design to improve efficiency; and (3) continuity-aware techniques, including cube-aware positional encoding, padding, and blending to eliminate boundary seams. Extensive experiments on benchmark datasets demonstrate that CubeComposer outperforms state-of-the-art methods in native resolution and visual quality, supporting practical VR application scenarios. Project page: https://lg-li.github.io/project/cubecomposer
Abstract:The D4D Dataset provides paired endoscopic video and high-quality structured-light geometry for evaluating 3D reconstruction of deforming abdominal soft tissue in realistic surgical conditions. Data were acquired from six porcine cadaver sessions using a da Vinci Xi stereo endoscope and a Zivid structured-light camera, registered via optical tracking and manually curated iterative alignment methods. Three sequence types - whole deformations, incremental deformations, and moved-camera clips - probe algorithm robustness to non-rigid motion, deformation magnitude, and out-of-view updates. Each clip provides rectified stereo images, per-frame instrument masks, stereo depth, start/end structured-light point clouds, curated camera poses and camera intrinsics. In postprocessing, ICP and semi-automatic registration techniques are used to register data, and instrument masks are created. The dataset enables quantitative geometric evaluation in both visible and occluded regions, alongside photometric view-synthesis baselines. Comprising over 300,000 frames and 369 point clouds across 98 curated recordings, this resource can serve as a comprehensive benchmark for developing and evaluating non-rigid SLAM, 4D reconstruction, and depth estimation methods.
Abstract:Endoluminal surgery offers a minimally invasive option for early-stage gastrointestinal and urinary tract cancers but is limited by surgical tools and a steep learning curve. Robotic systems, particularly continuum robots, provide flexible instruments that enable precise tissue resection, potentially improving outcomes. This paper presents a visual perception platform for a continuum robotic system in endoluminal surgery. Our goal is to utilize monocular endoscopic image-based perception algorithms to identify position and orientation of flexible instruments and measure their distances from tissues. We introduce 2D and 3D learning-based perception algorithms and develop a physically-realistic simulator that models flexible instruments dynamics. This simulator generates realistic endoluminal scenes, enabling control of flexible robots and substantial data collection. Using a continuum robot prototype, we conducted module and system-level evaluations. Results show that our algorithms improve control of flexible instruments, reducing manipulation time by over 70% for trajectory-following tasks and enhancing understanding of surgical scenarios, leading to robust endoluminal surgeries.