Chengan Che

Chengan Che, Chao Wang, Jiayuan Huang et al.

Recent advancements in self-supervised learning have led to powerful surgical vision encoders capable of spatiotemporal understanding. However, extending these visual foundations to multi-modal reasoning tasks is severely bottlenecked by the prohibitive cost of expert textual annotations. To overcome this scalability limitation, we introduce \textbf{LIME}, a large-scale multi-modal dataset derived from open-access surgical videos using human-free, Large Language Model (LLM)-generated narratives. While LIME offers immense scalability, unverified generated texts may contain errors, including hallucinations, that could potentially lead to catastrophically degraded pre-trained medical priors in standard contrastive pipelines. To mitigate this, we propose \textbf{SurgLIME}, a parameter-efficient Vision-Language Pre-training (VLP) framework designed to learn reliable cross-modal alignments using noisy narratives. SurgLIME preserves foundational medical priors using a LoRA-adapted dual-encoder architecture and introduces an automated confidence estimation mechanism that dynamically down-weights uncertain text during contrastive alignment. Evaluations on the AutoLaparo and Cholec80 benchmarks show that SurgLIME achieves competitive zero-shot cross-modal alignment while preserving the robust linear probing performance of the visual foundation model. Dataset, code, and models are publicly available at \href{https://github.com/visurg-ai/SurgLIME}{https://github.com/visurg-ai/SurgLIME}.

Chengan Che, Chao Wang, Tom Vercauteren et al.

Traditional open-access datasets focusing on surgical procedures are often limited by their small size, typically consisting of fewer than 100 videos and less than 30 hours of footage, which leads to poor model generalization. To address this constraint, a new dataset called LEMON has been compiled using a novel aggregation pipeline that collects high-resolution videos from online sources. Featuring an extensive collection of over 4K surgical videos totaling 938 hours (85 million frames) of high-quality footage across multiple procedure types, LEMON offers a comprehensive resource surpassing existing alternatives in size and scope, including two novel downstream tasks. To demonstrate the effectiveness of this diverse dataset, we introduce LemonFM, a foundation model pretrained on LEMON using a novel self-supervised augmented knowledge distillation approach. LemonFM consistently outperforms existing surgical foundation models across four downstream tasks and six datasets, achieving significant gains in surgical phase recognition (+9.5pp, +9.4pp, and +8.4pp of Jaccard in AutoLaparo, M2CAI16, and Cholec80), surgical action recognition (+4.4pp of mAP in CholecT50), surgical tool presence detection (+5.3pp and +10.2pp of mAP in Cholec80 and GraSP), and surgical semantic segmentation (+8.3pp of mDice in CholecSeg8k). LEMON and LemonFM will serve as foundational resources for the research community and industry, accelerating progress in developing autonomous robotic surgery systems and ultimately contributing to safer and more accessible surgical care worldwide.

Chao Wang, Chengan Che, Xinyue Chen et al.

Counterfactual explanations (CFEs) are minimal and semantically meaningful modifications of the input of a model that alter the model predictions. They highlight the decisive features the model relies on, providing contrastive interpretations for classifiers. State-of-the-art visual counterfactual explanation methods are designed to explain image classifiers. The generation of CFEs for video classifiers remains largely underexplored. For the counterfactual videos to be useful, they have to be physically plausible, temporally coherent, and exhibit smooth motion trajectories. Existing CFE image-based methods, designed to explain image classifiers, lack the capacity to generate temporally coherent, smooth and physically plausible video CFEs. To address this, we propose Back To The Feature (BTTF), an optimization framework that generates video CFEs. Our method introduces two novel features, 1) an optimization scheme to retrieve the initial latent noise conditioned by the first frame of the input video, 2) a two-stage optimization strategy to enable the search for counterfactual videos in the vicinity of the input video. Both optimization processes are guided solely by the target classifier, ensuring the explanation is faithful. To accelerate convergence, we also introduce a progressive optimization strategy that incrementally increases the number of denoising steps. Extensive experiments on video datasets such as Shape-Moving (motion classification), MEAD (emotion classification), and NTU RGB+D (action classification) show that our BTTF effectively generates valid, visually similar and realistic counterfactual videos that provide concrete insights into the classifier's decision-making mechanism.

Chengan Che, Chao Wang, Xinyue Chen et al.

Procedural activities, ranging from routine cooking to complex surgical operations, are highly structured as a set of actions conducted in a specific temporal order. Despite their success on static images and short clips, current self-supervised learning methods often overlook the procedural nature that underpins such activities. We expose the lack of procedural awareness in current SSL methods with a motivating experiment: models pretrained on forward and time-reversed sequences produce highly similar features, confirming that their representations are blind to the underlying procedural order. To address this shortcoming, we propose PL-Stitch, a self-supervised framework that harnesses the inherent temporal order of video frames as a powerful supervisory signal. Our approach integrates two novel probabilistic objectives based on the Plackett-Luce (PL) model. The primary PL objective trains the model to sort sampled frames chronologically, compelling it to learn the global workflow progression. The secondary objective, a spatio-temporal jigsaw loss, complements the learning by capturing fine-grained, cross-frame object correlations. Our approach consistently achieves superior performance across five surgical and cooking benchmarks. Specifically, PL-Stitch yields significant gains in surgical phase recognition (e.g., +11.4 pp k-NN accuracy on Cholec80) and cooking action segmentation (e.g., +5.7 pp linear probing accuracy on Breakfast), demonstrating its effectiveness for procedural video representation learning.