EndoWAM: A Grounded World-Action Model for Generalizable Endoscopic Navigation

Autonomous endoscopic navigation can reduce clinicians' operational burden, yet robust control remains challenging due to tissue deformation, transient occlusions, and rapidly changing viewpoints. Existing learning-based policies typically predict actions from current observations without explicitly modeling future dynamics, limiting their robustness and reliability in safety-critical settings. World Action Models (WAMs) offer a promising alternative by coupling predictive visual dynamics with action generation, but extending them to robotic endoscopy remains challenging due to limited training data, restricted viewpoint diversity, deformable anatomy, and high inference latency. We present EndoWAM, which is, to our knowledge, the first WAM for generalizable robotic endoscopic navigation. EndoWAM introduces future grounding, which predicts task-relevant target regions in future observations from intermediate denoising features of a video world model. Specifically, EndoWAM couples a lightweight diffusion transformer for future target-region prediction with a discrete action expert through a shared predictive representation. This design injects target-aware supervision into predictive dynamics modeling, improving robustness to visual degradation and viewpoint changes while enabling real-time control in a single denoising pass. We further introduce EndoMotion, a robotic endoscopic motion dataset spanning three anatomically distinct procedures: ureteroscopy, esophagoscopy, and endoscopic retrograde cholangiopancreatography (ERCP). EndoWAM consistently outperforms all baselines and alternative grounding strategies, while demonstrating strong zero-shot generalization to unseen viewpoints, environments, and targets. These results establish EndoWAM as a predictive, target-grounded framework for accurate, generalizable, and long-horizon navigation in visually constrained endoscopic environments.

BiliVLA: Scene-Aware Vision-Language-Action Model with Reinforcement Learning for Autonomous Biliary Endoscopic Navigation

Endoscopic retrograde cholangiopancreatography (ERCP) demands precise endoscopic navigation and stable biliary cannulation within a narrow monocular field characterized by specular reflections, partial occlusions, and frequent tissue contact. Although recent robotic systems and vision-based assistance techniques improve operator ergonomics and provide perceptual cues, their performance degrades under pronounced anatomical variability and safety-critical visual artifacts, which hinders reliable autonomy in cannulation-grade procedures. Here, we present BiliVLA, a scene-aware Vision-Language-Action (VLA) framework that formulates biliary endoscopic navigation as an instruction-conditioned visuomotor learning problem. Given an endoscopic observation and a stage-specific language instruction, BiliVLA jointly predicts the target category, a grounded bounding box, and a discrete three degrees of freedom (DoF) motor command for a continuum endoscope. The proposed framework incorporates scene-aware supervision to enhance semantic target consistency and safety-aware recovery supervision to induce conservative retreat behaviors under luminal wall contact. A key component of BiliVLA is a two-stage training paradigm that combines grounding-enhanced supervised fine-tuning (SFT) with Group Relative Policy Optimization (GRPO), which significantly improves action reliability and decision consistency during closed-loop navigation. Across three ERCP subtasks, BiliVLA achieves an average action precision of 91.96\% and an overall success rate (SR) of 84.85\% in real-world phantom experiments. These results indicate that integrating semantic grounding, scene-aware learning, and reward-guided optimization improves perception-action alignment and enables robust autonomous endoscopic navigation.