Kun Yuan

Meng Wei, Kun Yuan, Shi Li et al.

Enabling intuitive, language-driven interaction with surgical scenes is a critical step toward intelligent operating rooms and autonomous surgical robotic assistance. However, the task of referring segmentation, localizing surgical instruments based on natural language descriptions, remains underexplored in surgical videos, with existing approaches struggling to generalize due to reliance on static visual cues and predefined instrument names. In this work, we introduce SurgRef, a novel motion-guided framework that grounds free-form language expressions in instrument motion, capturing how tools move and interact across time, rather than what they look like. This allows models to understand and segment instruments even under occlusion, ambiguity, or unfamiliar terminology. To train and evaluate SurgRef, we present Ref-IMotion, a diverse, multi-institutional video dataset with dense spatiotemporal masks and rich motion-centric expressions. SurgRef achieves state-of-the-art accuracy and generalization across surgical procedures, setting a new benchmark for robust, language-driven surgical video segmentation.

Ruochen Li, Kun Yuan, Yufei Xia et al.

Surgical planning integrates visual perception, long-horizon reasoning, and procedural knowledge, yet it remains unclear whether current evaluation protocols reliably assess vision-language models (VLMs) in safety-critical settings. Motivated by a goal-oriented view of surgical planning, we define planning correctness via phase-goal satisfiability, where plan validity is determined by expert-defined surgical rules. Based on this definition, we introduce a multicentric meta-evaluation benchmark with valid procedural variations and invalid plans containing order and content errors. Using this benchmark, we show that sequence similarity metrics systematically misjudge planning quality, penalizing valid plans while failing to identify invalid ones. We therefore adopt a rule-based goal-satisfiability metric as a high-precision meta-evaluation reference to assess Video-LLMs under progressively constrained settings, revealing failures due to perception errors and under-constrained reasoning. Structural knowledge consistently improves performance, whereas semantic guidance alone is unreliable and benefits larger models only when combined with structural constraints.

Guankun Wang, Long Bai, Junyi Wang et al.

Recently, Multimodal Large Language Models (MLLMs) have demonstrated their immense potential in computer-aided diagnosis and decision-making. In the context of robotic-assisted surgery, MLLMs can serve as effective tools for surgical training and guidance. However, there is still a lack of MLLMs specialized for surgical scene understanding in clinical applications. In this work, we introduce EndoChat to address various dialogue paradigms and subtasks in surgical scene understanding that surgeons encounter. To train our EndoChat, we construct the Surg-396K dataset through a novel pipeline that systematically extracts surgical information and generates structured annotations based on collected large-scale endoscopic surgery datasets. Furthermore, we introduce a multi-scale visual token interaction mechanism and a visual contrast-based reasoning mechanism to enhance the model's representation learning and reasoning capabilities. Our model achieves state-of-the-art performance across five dialogue paradigms and eight surgical scene understanding tasks. Additionally, we conduct evaluations with professional surgeons, most of whom provide positive feedback on collaborating with EndoChat. Overall, these results demonstrate that our EndoChat has great potential to significantly advance training and automation in robotic-assisted surgery.

Jian Jiang, Chenxi Lin, Yiming Gu et al.

Surgical scene understanding demands not only accurate predictions but also interpretable reasoning that surgeons can verify against clinical expertise. However, existing surgical vision-language models generate predictions without reasoning chains, and general-purpose reasoning models fail on compositional surgical tasks without domain-specific knowledge. We present Surg-R1, a surgical Vision-Language Model that addresses this gap through hierarchical reasoning trained via a four-stage pipeline. Our approach introduces three key contributions: (1) a three-level reasoning hierarchy decomposing surgical interpretation into perceptual grounding, relational understanding, and contextual reasoning; (2) the largest surgical chain-of-thought dataset with 320,000 reasoning pairs; and (3) a four-stage training pipeline progressing from supervised fine-tuning to group relative policy optimization and iterative self-improvement. Evaluation on SurgBench, comprising six public benchmarks and six multi-center external validation datasets from five institutions, demonstrates that Surg-R1 achieves the highest Arena Score (64.9%) on public benchmarks versus Gemini 3.0 Pro (46.1%) and GPT-5.1 (37.9%), outperforming both proprietary reasoning models and specialized surgical VLMs on the majority of tasks spanning instrument localization, triplet recognition, phase recognition, action recognition, and critical view of safety assessment, with a 15.2 percentage point improvement over the strongest surgical baseline on external validation.

Jianshu Zeng, Yuxuan Liu, Yutong Feng et al.

Video relighting is a challenging yet valuable task, aiming to replace the background in videos while correspondingly adjusting the lighting in the foreground with harmonious blending. During translation, it is essential to preserve the original properties of the foreground, e.g., albedo, and propagate consistent relighting among temporal frames. In this paper, we propose Lumen, an end-to-end video relighting framework developed on large-scale video generative models, receiving flexible textual description for instructing the control of lighting and background. Considering the scarcity of high-qualified paired videos with the same foreground in various lighting conditions, we construct a large-scale dataset with a mixture of realistic and synthetic videos. For the synthetic domain, benefiting from the abundant 3D assets in the community, we leverage advanced 3D rendering engine to curate video pairs in diverse environments. For the realistic domain, we adapt a HDR-based lighting simulation to complement the lack of paired in-the-wild videos. Powered by the aforementioned dataset, we design a joint training curriculum to effectively unleash the strengths of each domain, i.e., the physical consistency in synthetic videos, and the generalized domain distribution in realistic videos. To implement this, we inject a domain-aware adapter into the model to decouple the learning of relighting and domain appearance distribution. We construct a comprehensive benchmark to evaluate Lumen together with existing methods, from the perspectives of foreground preservation and video consistency assessment. Experimental results demonstrate that Lumen effectively edit the input into cinematic relighted videos with consistent lighting and strict foreground preservation. Our project page: https://lumen-relight.github.io/

Jiaojiao Zhang, Yuqi Xu, Kun Yuan

This work addresses the key challenges of applying federated learning to large-scale deep neural networks, particularly the issue of client drift due to data heterogeneity across clients and the high costs of communication, computation, and memory. We propose FedSub, an efficient subspace algorithm for federated learning on heterogeneous data. Specifically, FedSub utilizes subspace projection to guarantee local updates of each client within low-dimensional subspaces, thereby reducing communication, computation, and memory costs. Additionally, it incorporates low-dimensional dual variables to mitigate client drift. We provide convergence analysis that reveals the impact of key factors such as step size and subspace projection matrices on convergence. Experimental results demonstrate its efficiency.