Huai Liao

Jinlin Wu, Felix Holm, Chuxi Chen et al.

While foundation models have advanced surgical video analysis, current approaches rely predominantly on pixel-level reconstruction objectives that waste model capacity on low-level visual details - such as smoke, specular reflections, and fluid motion - rather than semantic structures essential for surgical understanding. We present UniSurg, a video-native foundation model that shifts the learning paradigm from pixel-level reconstruction to latent motion prediction. Built on the Video Joint Embedding Predictive Architecture (V-JEPA), UniSurg introduces three key technical innovations tailored to surgical videos: 1) motion-guided latent prediction to prioritize semantically meaningful regions, 2) spatiotemporal affinity self-distillation to enforce relational consistency, and 3) feature diversity regularization to prevent representation collapse in texture-sparse surgical scenes. To enable large-scale pretraining, we curate UniSurg-15M, the largest surgical video dataset to date, comprising 3,658 hours of video from 50 sources across 13 anatomical regions. Extensive experiments across 17 benchmarks demonstrate that UniSurg significantly outperforms state-of-the-art methods on surgical workflow recognition (+14.6% F1 on EgoSurgery, +10.3% on PitVis), action triplet recognition (39.54% mAP-IVT on CholecT50), skill assessment, polyp segmentation, and depth estimation. These results establish UniSurg as a new standard for universal, motion-oriented surgical video understanding.

Qingyao Tian, Bingyu Yang, Huai Liao et al.

Vision-language models (VLMs) have recently shown remarkable performance in navigation and localization tasks by leveraging large-scale pretraining for semantic understanding. However, applying VLMs to 6-DoF endoscopic camera localization presents several challenges: 1) the lack of large-scale, high-quality, densely annotated, and localization-oriented vision-language datasets in real-world medical settings; 2) limited capability for fine-grained pose regression; and 3) high computational latency when extracting temporal features from past frames. To address these issues, we first construct BREATH dataset, the largest in-vivo endoscopic localization dataset to date, collected in the complex human airway. Building on this dataset, we propose BREATH-VL, a hybrid framework that integrates semantic cues from VLMs with geometric information from vision-based registration methods for accurate 6-DoF pose estimation. Our motivation lies in the complementary strengths of both approaches: VLMs offer generalizable semantic understanding, while registration methods provide precise geometric alignment. To further enhance the VLM's ability to capture temporal context, we introduce a lightweight context-learning mechanism that encodes motion history as linguistic prompts, enabling efficient temporal reasoning without expensive video-level computation. Extensive experiments demonstrate that the vision-language module delivers robust semantic localization in challenging surgical scenes. Building on this, our BREATH-VL outperforms state-of-the-art vision-only localization methods in both accuracy and generalization, reducing translational error by 25.5% compared with the best-performing baseline, while achieving competitive computational latency.