Kun Yuan

Kun Yuan, Vinkle Srivastav, Nassir Navab et al.

Surgical video-language pretraining (VLP) faces unique challenges due to the knowledge domain gap and the scarcity of multi-modal data. This study aims to bridge the gap by addressing issues regarding textual information loss in surgical lecture videos and the spatial-temporal challenges of surgical VLP. We propose a hierarchical knowledge augmentation approach and a novel Procedure-Encoded Surgical Knowledge-Augmented Video-Language Pretraining (PeskaVLP) framework to tackle these issues. The knowledge augmentation uses large language models (LLM) for refining and enriching surgical concepts, thus providing comprehensive language supervision and reducing the risk of overfitting. PeskaVLP combines language supervision with visual self-supervision, constructing hard negative samples and employing a Dynamic Time Warping (DTW) based loss function to effectively comprehend the cross-modal procedural alignment. Extensive experiments on multiple public surgical scene understanding and cross-modal retrieval datasets show that our proposed method significantly improves zero-shot transferring performance and offers a generalist visual representation for further advancements in surgical scene understanding.The code is available at https://github.com/CAMMA-public/SurgVLP

Kun Yuan, Vinkle Srivastav, Nassir Navab et al.

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

Xiangteng He, Shunsuke Sakai, Kun Yuan et al.

Image-based Joint-Embedding Predictive Architecture (I-JEPA) learns visual representations by predicting latent embeddings of masked regions from visible context. However, it treats all regions uniformly and independently, lacking an explicit notion of where or in what order predictions should be made. Inspired by human visual perception, which deploys attention selectively and sequentially from the most informative to secondary regions, we propose DSeq-JEPA, a Discriminative Sequential Joint-Embedding Predictive Architecture that bridges predictive and autoregressive self-supervised learning, integrating JEPA-style latent prediction with GPT-style sequential reasoning. Specifically, DSeq-JEPA (i) first identifies primary discriminative regions based on a transformer-derived saliency map, emphasizing the distribution of visual importance, and then (ii) predicts subsequent regions in this discriminative order, progressively forming a curriculum-like semantic progression from primary to secondary cues -- a form of GPT-style pre-training. Extensive experiments across diverse tasks, including image classification (ImageNet), fine-grained visual categorization (iNaturalist21, CUB-200-2011, Stanford-Cars), detection and segmentation (MS-COCO, ADE20K), and low-level reasoning tasks (Clevr/Count, Clevr/Dist), demonstrate that DSeq-JEPA consistently focuses on more discriminative and generalizable representations than I-JEPA variants. Project page: https://github.com/SkyShunsuke/DSeq-JEPA.

Ming Hu, Kun Yuan, Yaling Shen et al.

Surgical practice involves complex visual interpretation, procedural skills, and advanced medical knowledge, making surgical vision-language pretraining (VLP) particularly challenging due to this complexity and the limited availability of annotated data. To address the gap, we propose OphCLIP, a hierarchical retrieval-augmented vision-language pretraining framework specifically designed for ophthalmic surgical workflow understanding. OphCLIP leverages the OphVL dataset we constructed, a large-scale and comprehensive collection of over 375K hierarchically structured video-text pairs with tens of thousands of different combinations of attributes (surgeries, phases/operations/actions, instruments, medications, as well as more advanced aspects like the causes of eye diseases, surgical objectives, and postoperative recovery recommendations, etc). These hierarchical video-text correspondences enable OphCLIP to learn both fine-grained and long-term visual representations by aligning short video clips with detailed narrative descriptions and full videos with structured titles, capturing intricate surgical details and high-level procedural insights, respectively. Our OphCLIP also designs a retrieval-augmented pretraining framework to leverage the underexplored large-scale silent surgical procedure videos, automatically retrieving semantically relevant content to enhance the representation learning of narrative videos. Evaluation across 11 datasets for phase recognition and multi-instrument identification shows OphCLIP's robust generalization and superior performance.