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.

Frequency-Aware Flow Matching for Continuous and Consistent Robotic Action Generation

Flow matching has emerged as a standard paradigm for robotic manipulation owing to its strong expressive power for modelling complex, multimodal action distributions, alongside similar approaches like diffusion policy. However, existing methods rely on discretized action chunks, making them brittle to demonstrations collected at heterogeneous control frequencies and prone to temporally inconsistent actions that degrade control stability. In this paper, we propose Frequency-Aware Flow Matching (FAFM), which outputs continuous, temporally consistent actions. To handle heterogeneous frequency input, we transform discrete action sequences into the frequency domain with the discrete cosine transform (DCT), perform flow matching over the resulting coefficients, and reconstruct continuous actions via cosine basis expansion. To generate temporally consistent actions, we regularize the first-order temporal derivative to promote smooth actions. This corresponds to a Sobolev-type constraint that suppresses high-frequency errors and discourages abrupt action changes. Our FAFM is simple, introduces no additional network parameters and applies to standalone flow-matching policies and vision-language action models. Across synthetic toy benchmark, obstacle avoidance, LapGym, and LIBERO, FAFM improves success rates, multimodal expressivity, motion smoothness, convergence speed, robustness to mechanical bias and mixed-frequency input. These gains are consistent when deployed on a real-world Franka robot. Code available at https://anonymous.4open.science/r/FAFM.

Where Should Action Generation Begin? A Learnable Source Prior for Generative Robot Policies

Generative robot policies typically begin action generation from an observation-independent standard Gaussian distribution, leaving the choice of source distribution underexplored. This work asks a simple question: where should action generation begin? We propose LeaP, a Learnable source Prior that replaces the standard Gaussian with a proprioception-conditioned diagonal Gaussian over action chunks. Parameterized by a lightweight MLP, LeaP jointly predicts the mean and state-adaptive variance of the source distribution, while keeping the downstream generator architecture and inference solver unchanged. This design provides an observation-informed yet stochastic initialization, allowing the generator to focus on precise action refinement rather than transporting samples from an uninformed noise source. On 15 RoboTwin manipulation tasks, LeaP achieves an average success rate of 81.6%, outperforming four representative baselines -- including deterministic-source methods, a no-prior counterpart, and a diffusion-bridge policy -- by 6.5 to 25.5 percentage points. The same prior consistently improves both flow-matching and diffusion-bridge generators, while using fewer parameters and converging faster. The advantage carries over to real-world deployment, where LeaP attains the best performance. These results suggest that the source distribution is an independent and reusable design axis for generative robot policies, complementary to the choice of generative dynamics.

Scaling Parallel Sequence Models to Foundation-Scale Vision Encoders

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.

Geometry-Guided Modeling of Foundation Features Enables Generalizable Object Shape Deformation Learning

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/

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.

Saliency-R1: Enforcing Interpretable and Faithful Vision-language Reasoning via Saliency-map Alignment Reward

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.

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.

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.

Surg-R1: A Hierarchical Reasoning Foundation Model for Scalable and Interpretable Surgical Decision Support with Multi-Center Clinical Validation

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.