Capstan-driven Continuum Surgical Robot: Design, Modeling, and Perception

Shape and force sensing have long been critical bottlenecks in the development of compact capstan-driven continuum surgical robots, primarily due to the difficulty of obtaining cable tension information within the confined capstan assembly. To overcome these challenges, this paper presents an integrated design-modeling-sensing approach based on the concept of actuation-perception co-design. A compliant element is introduced into the motor mounting bracket of the drive system, enabling micro-deformation under the cable reaction force and thereby allowing real-time cable tension measurement without occupying the compact capstan space. To address the modeling complexity arising from unconventional joint configurations introduced by the spatial cable routing strategy, a parallel computation framework based on a multibody short-thick-beam model is proposed, which captures shear effects in short beam segments and synergistic multi-cable interactions while achieving real-time performance. Building on this framework, stable shape and force sensing is achieved by incorporating a proximal multi-axis force/torque sensor as an additional measurement anchor. Following this design-modeling-sensing framework, capstan-driven continuum surgical robots with single- and dual-segment configurations are developed. Experimental results validate the proposed framework in both single- and dual-segment continuum robots, demonstrating real-time tip pose estimation together with contact force and location perception. By enabling cable tension feedback without compromising the compact capstan architecture, the proposed framework makes integrated perception feasible for capstan-driven continuum surgical robots.

ExtraGS: Enhancing Endoscopic View Extrapolation via Diffusion-Guided 3D Gaussian Splatting

Robot-assisted minimally invasive surgery (MIS) critically depends on reliable endoscopic perception for navigation and safety. However, conventional endoscopes provide only a limited field of view, leaving large portions of surrounding anatomy unobserved. Recent neural rendering approaches, such as Neural Radiance Fields and 3D Gaussian Splatting, enable novel view synthesis from endoscopic videos, but their reliance on sparse observations often leads to severe artifacts when extrapolating beyond the training trajectory.In this work, we propose ExtraGS, a framework for enhancing endoscopic view extrapolation via diffusion-guided 3D Gaussian Splatting. Starting from an initial reconstruction, we introduce an uncertainty-guided virtual camera sampling strategy to actively explore blind spots and maximize information gain. The rendered views from these sampled locations are refined using a diffusion model to recover plausible anatomical structures, producing pseudo observations that guide further optimization. To prevent the generated content from degrading reliable regions, we adopt a confidence-weighted fine-tuning strategy when incorporating these pseudo observations.Extensive experiments on multiple public endoscopic datasets demonstrate that ExtraGS significantly reduces extrapolation artifacts and achieves state-of-the-art performance in endoscopic novel view synthesis.

DreamReg: Belief-Driven World Model for 2D-3D Ultrasound Registration

Ultrasound (US) is widely used for surgical navigation, yet real-time registration between intraoperative 2D slices and preoperative 3D volumes remains challenging due to partial observability, speckle noise, and the action-dependent US acquisition. Existing methods are one-shot or short-horizon, making it hard for them to gather evidence over time or capture how surgeons adjust probe motion based on on-screen feedback. We propose DreamReg, a belief-driven world-model framework that formulates 2D-3D registration as belief updating over rigid transformations. DreamReg maintains a latent belief state that summarizes past observations and poses information, and continuously refines the transformation through learned dynamics as new slices arrive. During training, DreamReg is exposed to probe-motion trajectories that mimic clinical scanning behavior and learns to update its belief by conditioning pose refinement on the current US observation. During inference, DreamReg refines registration via internal imagination: it rolls out the learned world model to simulate candidate probe motions and their predicted observations, and integrates these imagined outcomes to converge to an accurate rigid transformation. Experiments on CAMUS and u-RegPro datasets demonstrate improved robustness and competitive registration accuracy for real-time guidance compared with state-of-the-art methods.

Stiffness Optimization for Concentrated Bending in Magnetically Actuated Catheters: Maintaining Steerability under Gradient Stiffness

Achieving both efficient pushability (propulsion transmission) and proximally concentrated bending for steerability is challenging for magnetically actuated soft catheters: higher axial/bending stiffness improves force transmission but reduces steerability, whereas lower stiffness enables large, proximally concentrated bending yet increases kinking/buckling risk under compressive push loads. To address this trade-off, we propose a stiffness-optimized multi-segment magnetically actuated catheter (SO-MAC) that integrates a decoupled steering-advancement mechanism with a gradient-stiffness architecture. The SO-MAC concentrates bending about a stable proximal pivot during advancement while the distal section passively self-straightens to transmit propulsion, aided by the optimized stiffness distribution and elastic recovery of the spring backbone against friction-induced kinking/buckling. Over $0{-}180^{\circ}$ combined steering and advancement, the pivot remained stable and the distal tip advanced near-straight toward the target direction. A 1.5 mm-diameter SO-MAC achieved up to $180^{\circ}$ steering with a 3 mm bending radius at its 10 mm tip, with an average shape error of $1.39 \pm 0.56$ mm and a steering-pivot error of $0.35 \pm 0.10$ mm. Visual feedback control in a bronchial phantom further confirmed robust navigation through highly curved, bifurcating paths.

Information-Theoretic Geometry Optimization and Physics-Aware Learning for Calibration-Free Magnetic Localization

Wireless localization of permanent magnets enables occlusion-free guidance for medical interventions, yet its practical accuracy is fundamentally limited by two coupled challenges: the poor observability of conventional planar sensor arrays and the simulation-to-reality (Sim-to-Real) gap of learning-based estimators. To address these issues, this article presents a unified framework that combines information-theoretic sensor geometry optimization with physics-aware deep learning. First, a rigorous Fisher Information Matrix (FIM)-based evaluation framework is established to quantify geometry-induced observability limitations. The results show that a staggered split-array topology provides a substantially stronger observability foundation for localization while remaining compatible with practical external deployment. Second, building on this optimized sensing configuration, we propose Phy-GAANet, a calibration-free estimator trained entirely on hardware-aware synthetic data. By incorporating Physics-Informed Features (PIF) for saturation modeling and Geometry-Aware Attention (GAA) for preserving cross-layer vector structure, the network effectively bridges the Sim-to-Real gap. Extensive real-world experiments demonstrate state-of-the-art performance, achieving a position error of 1.84 mm and an orientation error of 3.18 degrees at a refresh rate exceeding 270 Hz. The proposed method consistently outperforms classical Levenberg--Marquardt solvers and generic convolutional baselines, particularly in suppressing catastrophic outliers and maintaining robustness in challenging near-field boundary regions. Beyond the proposed network, the FIM-guided analysis also provides a framework for sensor geometry design in magnetic localization systems under practical deployment constraints.

A Vision-Language-Action Model for Adaptive Ultrasound-Guided Needle Insertion and Needle Tracking

Ultrasound (US)-guided needle insertion is a critical yet challenging procedure due to dynamic imaging conditions and difficulties in needle visualization. Many methods have been proposed for automated needle insertion, but they often rely on hand-crafted pipelines with modular controllers, whose performance degrades in challenging cases. In this paper, a Vision-Language-Action (VLA) model is proposed for adaptive and automated US-guided needle insertion and tracking on a robotic ultrasound (RUS) system. This framework provides a unified approach to needle tracking and needle insertion control, enabling real-time, dynamically adaptive adjustment of insertion based on the obtained needle position and environment awareness. To achieve real-time and end-to-end tracking, a Cross-Depth Fusion (CDF) tracking head is proposed, integrating shallow positional and deep semantic features from the large-scale vision backbone. To adapt the pretrained vision backbone for tracking tasks, a Tracking-Conditioning (TraCon) register is introduced for parameter-efficient feature conditioning. After needle tracking, an uncertainty-aware control policy and an asynchronous VLA pipeline are presented for adaptive needle insertion control, ensuring timely decision-making for improved safety and outcomes. Extensive experiments on both needle tracking and insertion show that our method consistently outperforms state-of-the-art trackers and manual operation, achieving higher tracking accuracy, improved insertion success rates, and reduced procedure time, highlighting promising directions for RUS-based intelligent intervention.

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.

Leveraging Geometric Prior Uncertainty and Complementary Constraints for High-Fidelity Neural Indoor Surface Reconstruction

Neural implicit surface reconstruction with signed distance function has made significant progress, but recovering fine details such as thin structures and complex geometries remains challenging due to unreliable or noisy geometric priors. Existing approaches rely on implicit uncertainty that arises during optimization to filter these priors, which is indirect and inefficient, and masking supervision in high-uncertainty regions further leads to under-constrained optimization. To address these issues, we propose GPU-SDF, a neural implicit framework for indoor surface reconstruction that leverages geometric prior uncertainty and complementary constraints. We introduce a self-supervised module that explicitly estimates prior uncertainty without auxiliary networks. Based on this estimation, we design an uncertainty-guided loss that modulates prior influence rather than discarding it, thereby retaining weak but informative cues. To address regions with high prior uncertainty, GPU-SDF further incorporates two complementary constraints: an edge distance field that strengthens boundary supervision and a multi-view consistency regularization that enforces geometric coherence. Extensive experiments confirm that GPU-SDF improves the reconstruction of fine details and serves as a plug-and-play enhancement for existing frameworks. Source code will be available at https://github.com/IRMVLab/GPU-SDF

4D Monocular Surgical Reconstruction under Arbitrary Camera Motions

Reconstructing deformable surgical scenes from endoscopic videos is challenging and clinically important. Recent state-of-the-art methods based on implicit neural representations or 3D Gaussian splatting have made notable progress. However, most are designed for deformable scenes with fixed endoscope viewpoints and rely on stereo depth priors or accurate structure-from-motion for initialization and optimization, limiting their ability to handle monocular sequences with large camera motion in real clinical settings. To address this, we propose Local-EndoGS, a high-quality 4D reconstruction framework for monocular endoscopic sequences with arbitrary camera motion. Local-EndoGS introduces a progressive, window-based global representation that allocates local deformable scene models to each observed window, enabling scalability to long sequences with substantial motion. To overcome unreliable initialization without stereo depth or accurate structure-from-motion, we design a coarse-to-fine strategy integrating multi-view geometry, cross-window information, and monocular depth priors, providing a robust foundation for optimization. We further incorporate long-range 2D pixel trajectory constraints and physical motion priors to improve deformation plausibility. Experiments on three public endoscopic datasets with deformable scenes and varying camera motions show that Local-EndoGS consistently outperforms state-of-the-art methods in appearance quality and geometry. Ablation studies validate the effectiveness of our key designs. Code will be released upon acceptance at: https://github.com/IRMVLab/Local-EndoGS.

NRGS-SLAM: Monocular Non-Rigid SLAM for Endoscopy via Deformation-Aware 3D Gaussian Splatting

Visual simultaneous localization and mapping (V-SLAM) is a fundamental capability for autonomous perception and navigation. However, endoscopic scenes violate the rigidity assumption due to persistent soft-tissue deformations, creating a strong coupling ambiguity between camera ego-motion and intrinsic deformation. Although recent monocular non-rigid SLAM methods have made notable progress, they often lack effective decoupling mechanisms and rely on sparse or low-fidelity scene representations, which leads to tracking drift and limited reconstruction quality. To address these limitations, we propose NRGS-SLAM, a monocular non-rigid SLAM system for endoscopy based on 3D Gaussian Splatting. To resolve the coupling ambiguity, we introduce a deformation-aware 3D Gaussian map that augments each Gaussian primitive with a learnable deformation probability, optimized via a Bayesian self-supervision strategy without requiring external non-rigidity labels. Building on this representation, we design a deformable tracking module that performs robust coarse-to-fine pose estimation by prioritizing low-deformation regions, followed by efficient per-frame deformation updates. A carefully designed deformable mapping module progressively expands and refines the map, balancing representational capacity and computational efficiency. In addition, a unified robust geometric loss incorporates external geometric priors to mitigate the inherent ill-posedness of monocular non-rigid SLAM. Extensive experiments on multiple public endoscopic datasets demonstrate that NRGS-SLAM achieves more accurate camera pose estimation (up to 50\% reduction in RMSE) and higher-quality photo-realistic reconstructions than state-of-the-art methods. Comprehensive ablation studies further validate the effectiveness of our key design choices. Source code will be publicly available upon paper acceptance.