Aiza Maksutova

Aiza Maksutova, Lalithkumar Seenivasan, Hao Ding et al.

Surgical action automation has progressed rapidly toward achieving surgeon-like dexterous control, driven primarily by advances in learning from demonstration and vision-language-action models. While these have demonstrated success in table-top experiments, translating them to clinical deployment remains challenging: current methods offer limited predictability on where instruments will interact on tissue surfaces and lack explicit conditioning inputs to enforce tool-action-specific safe interaction regions. Addressing this gap, we introduce AffordTissue, a multimodal framework for predicting tool-action specific tissue affordance regions as dense heatmaps during cholecystectomy. Our approach combines a temporal vision encoder capturing tool motion and tissue dynamics across multiple viewpoints, language conditioning enabling generalization across diverse instrument-action pairs, and a DiT-style decoder for dense affordance prediction. We establish the first tissue affordance benchmark by curating and annotating 15,638 video clips across 103 cholecystectomy procedures, covering six unique tool-action pairs involving four instruments (hook, grasper, scissors, clipper) and their associated tasks: dissection, grasping, clipping, and cutting. Experiments demonstrate substantial improvement over vision-language model baselines (20.6 px ASSD vs. 60.2 px for Molmo-VLM), showing that our task-specific architecture outperforms large-scale foundation models for dense surgical affordance prediction. By predicting tool-action specific tissue affordance regions, AffordTissue provides explicit spatial reasoning for safe surgical automation, potentially unlocking explicit policy guidance toward appropriate tissue regions and early safe stop when instruments deviate outside predicted safe zones.

Dominik Schneider, Lalithkumar Seenivasan, Sampath Rapuri et al.

Purpose: Curating large-scale datasets of operating room (OR) workflow, encompassing rare, safety-critical, or atypical events, remains operationally and ethically challenging. This data bottleneck complicates the development of ambient intelligence for detecting, understanding, and mitigating rare or safety-critical events in the OR. Methods: This work presents an OR video diffusion framework that enables controlled synthesis of rare and safety-critical events. The framework integrates a geometric abstraction module, a conditioning module, and a fine-tuned diffusion model to first transform OR scenes into abstract geometric representations, then condition the synthesis process, and finally generate realistic OR event videos. Using this framework, we also curate a synthetic dataset to train and validate AI models for detecting near-misses of sterile-field violations. Results: In synthesizing routine OR events, our method outperforms off-the-shelf video diffusion baselines, achieving lower FVD/LPIPS and higher SSIM/PSNR in both in- and out-of-domain datasets. Through qualitative results, we illustrate its ability for controlled video synthesis of counterfactual events. An AI model trained and validated on the generated synthetic data achieved a RECALL of 70.13% in detecting near safety-critical events. Finally, we conduct an ablation study to quantify performance gains from key design choices. Conclusion: Our solution enables controlled synthesis of routine and rare OR events from abstract geometric representations. Beyond demonstrating its capability to generate rare and safety-critical scenarios, we show its potential to support the development of ambient intelligence models.

Yiqing Shen, Aiza Maksutova, Chenjia Li et al.

World models learn to predict the temporal evolution of visual observations given a control signal, potentially enabling agents to reason about environments through forward simulation. Because of the focus on forward simulation, current world models generate predictions based on factual observations. For many emerging applications, such as comprehensive evaluations of physical AI behavior under varying conditions, the ability of world models to answer counterfactual queries, such as "what would happen if this object was removed?", is of increasing importance. We formalize counterfactual world models that additionally take interventions as explicit inputs, predicting temporal sequences under hypothetical modifications to observed scene properties. Traditional world models operate directly on entangled pixel-space representations where object properties and relationships cannot be selectively modified. This modeling choice prevents targeted interventions on specific scene properties. We introduce CWMDT, a framework to overcome those limitations, turning standard video diffusion models into effective counterfactual world models. First, CWMDT constructs digital twins of observed scenes to explicitly encode objects and their relationships, represented as structured text. Second, CWMDT applies large language models to reason over these representations and predict how a counterfactual intervention propagates through time to alter the observed scene. Third, CWMDT conditions a video diffusion model with the modified representation to generate counterfactual visual sequences. Evaluations on two benchmarks show that the CWMDT approach achieves state-of-the-art performance, suggesting that alternative representations of videos, such as the digital twins considered here, offer powerful control signals for video forward simulation-based world models.