Understanding Multimodal Failure in Action-Chunking Behavioral Cloning

Behavioral cloning becomes difficult when the same observation admits several valid actions. We study this problem for action-chunking policies and show that different multimodal parameterizations fail in different ways. For latent-variable policies, posterior-prior regularization makes deployment-time sampling more reliable, but excessive regularization removes the action-conditioned information needed to distinguish demonstrated modes. Reducing this regularization can preserve mode information, but then success depends on whether the prior covers the relevant latent regions. For action-space generative policies, multimodality is constrained by the smoothness of the base-to-action transport: a map with small Lipschitz constant cannot assign substantial probability to many well-separated modes. Covering many modes therefore requires either sharp transitions in base space or off-support bridge regions in action space. Experiments on synthetic multimodal tasks and robotic simulation benchmarks support these mechanisms.

OSS: Open Suturing Skills Vision-Based Assessment Challenge 2024-2025

Achieving high levels of surgical skill through effective training is essential for optimal patient outcomes. Automated, data-driven skill assessment holds significant potential to improve surgical training. While machine learning-based methods are increasingly popular for assessing skills in minimally invasive surgery, their application to open surgery remains limited. We present the results of a dedicated MICCAI challenge designed to benchmark and advance vision-based skill assessment in open surgery. The challenge dataset comprises videos of an open suturing training task recorded with a static GoPro camera in a dry-lab setting, with instrument trajectories available in addition to the primary video modality. The OSS Challenge was hosted over two consecutive years, comprising two and three independent tasks, respectively: (1) classifying skill level into four classes, (2) predicting the full Objective Structured Assessment of Technical Skills across eight categories, and (3) tracking hands and surgical tools. Participants submitted diverse solutions including deep learning-based video models, tracking-driven methods, and hybrid approaches. General-purpose spatiotemporal video models consistently achieved the strongest performance, though conceptually diverse approaches reached competitive levels when well-executed. Predicting fine-grained OSATS scores remains challenging but benefits substantially from increased training data. Keypoint tracking proves difficult given frequent occlusions and out-of-frame instances, limiting current applicability for motion-based skill analysis. This work benchmarks innovative and diverse solutions for surgical skill assessment, highlighting both the promise and current limitations of video-based evaluation in open surgery and identifying critical directions for advancing automated skill assessment toward clinical impact.

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.

An Open-Source Robotics Research Platform for Autonomous Laparoscopic Surgery

Autonomous robot-assisted surgery demands reliable, high-precision platforms that strictly adhere to the safety and kinematic constraints of minimally invasive procedures. Existing research platforms, primarily based on the da Vinci Research Kit, suffer from cable-driven mechanical limitations that degrade state-space consistency and hinder the downstream training of reliable autonomous policies. We present an open-source, robot-agnostic Remote Center of Motion (RCM) controller based on a closed-form analytical velocity solver that enforces the trocar constraint deterministically without iterative optimization. The controller operates in Cartesian space, enabling any industrial manipulator to function as a surgical robot. We provide implementations for the UR5e and Franka Emika Panda manipulators, and integrate stereoscopic 3D perception. We integrate the robot control into a full-stack ROS-based surgical robotics platform supporting teleoperation, demonstration recording, and deployment of learned policies via a decoupled server-client architecture. We validate the system on a bowel grasping and retraction task across phantom, ex vivo, and in vivo porcine laparoscopic procedures. RCM deviations remain sub-millimeter across all conditions, and trajectory smoothness metrics (SPARC, LDLJ) are comparable to expert demonstrations from the JIGSAWS benchmark recorded on the da Vinci system. These results demonstrate that the platform provides the precision and robustness required for teleoperation, data collection and autonomous policy deployment in realistic surgical scenarios.

The Dresden Dataset for 4D Reconstruction of Non-Rigid Abdominal Surgical Scenes

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.

A benchmark for video-based laparoscopic skill analysis and assessment

Laparoscopic surgery is a complex surgical technique that requires extensive training. Recent advances in deep learning have shown promise in supporting this training by enabling automatic video-based assessment of surgical skills. However, the development and evaluation of deep learning models is currently hindered by the limited size of available annotated datasets. To address this gap, we introduce the Laparoscopic Skill Analysis and Assessment (LASANA) dataset, comprising 1270 stereo video recordings of four basic laparoscopic training tasks. Each recording is annotated with a structured skill rating, aggregated from three independent raters, as well as binary labels indicating the presence or absence of task-specific errors. The majority of recordings originate from a laparoscopic training course, thereby reflecting a natural variation in the skill of participants. To facilitate benchmarking of both existing and novel approaches for video-based skill assessment and error recognition, we provide predefined data splits for each task. Furthermore, we present baseline results from a deep learning model as a reference point for future comparisons.

Adaptive-CaRe: Adaptive Causal Regularization for Robust Outcome Prediction

Accurate prediction of outcomes is crucial for clinical decision-making and personalized patient care. Supervised machine learning algorithms, which are commonly used for outcome prediction in the medical domain, optimize for predictive accuracy, which can result in models latching onto spurious correlations instead of robust predictors. Causal structure learning methods on the other hand have the potential to provide robust predictors for the target, but can be too conservative because of algorithmic and data assumptions, resulting in loss of diagnostic precision. Therefore, we propose a novel model-agnostic regularization strategy, Adaptive-CaRe, for generalized outcome prediction in the medical domain. Adaptive-CaRe strikes a balance between both predictive value and causal robustness by incorporating a penalty that is proportional to the difference between the estimated statistical contribution and estimated causal contribution of the input features for model predictions. Our experiments on synthetic data establish the efficacy of the proposed Adaptive-CaRe regularizer in finding robust predictors for the target while maintaining competitive predictive accuracy. With experiments on a standard causal benchmark, we provide a blueprint for navigating the trade-off between predictive accuracy and causal robustness by tweaking the regularization strength, $λ$. Validation using real-world dataset confirms that the results translate to practical, real-domain settings. Therefore, Adaptive-CaRe provides a simple yet effective solution to the long-standing trade-off between predictive accuracy and causal robustness in the medical domain. Future work would involve studying alternate causal structure learning frameworks and complex classification models to provide deeper insights at a larger scale.

MoLF: Mixture-of-Latent-Flow for Pan-Cancer Spatial Gene Expression Prediction from Histology

Inferring spatial transcriptomics (ST) from histology enables scalable histogenomic profiling, yet current methods are largely restricted to single-tissue models. This fragmentation fails to leverage biological principles shared across cancer types and hinders application to data-scarce scenarios. While pan-cancer training offers a solution, the resulting heterogeneity challenges monolithic architectures. To bridge this gap, we introduce MoLF (Mixture-of-Latent-Flow), a generative model for pan-cancer histogenomic prediction. MoLF leverages a conditional Flow Matching objective to map noise to the gene latent manifold, parameterized by a Mixture-of-Experts (MoE) velocity field. By dynamically routing inputs to specialized sub-networks, this architecture effectively decouples the optimization of diverse tissue patterns. Our experiments demonstrate that MoLF establishes a new state-of-the-art, consistently outperforming both specialized and foundation model baselines on pan-cancer benchmarks. Furthermore, MoLF exhibits zero-shot generalization to cross-species data, suggesting it captures fundamental, conserved histo-molecular mechanisms.

HistoPrism: Unlocking Functional Pathway Analysis from Pan-Cancer Histology via Gene Expression Prediction

Predicting spatial gene expression from H&E histology offers a scalable and clinically accessible alternative to sequencing, but realizing clinical impact requires models that generalize across cancer types and capture biologically coherent signals. Prior work is often limited to per-cancer settings and variance-based evaluation, leaving functional relevance underexplored. We introduce HistoPrism, an efficient transformer-based architecture for pan-cancer prediction of gene expression from histology. To evaluate biological meaning, we introduce a pathway-level benchmark, shifting assessment from isolated gene-level variance to coherent functional pathways. HistoPrism not only surpasses prior state-of-the-art models on highly variable genes , but also more importantly, achieves substantial gains on pathway-level prediction, demonstrating its ability to recover biologically coherent transcriptomic patterns. With strong pan-cancer generalization and improved efficiency, HistoPrism establishes a new standard for clinically relevant transcriptomic modeling from routinely available histology.