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Main Authors: Yuan, Kun, Chen, Tingxuan, Li, Shi, Lavanchy, Joel L., Heiliger, Christian, Özsoy, Ege, Huang, Yiming, Bai, Long, Navab, Nassir, Srivastav, Vinkle, Ren, Hongliang, Padoy, Nicolas
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2506.20254
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author Yuan, Kun
Chen, Tingxuan
Li, Shi
Lavanchy, Joel L.
Heiliger, Christian
Özsoy, Ege
Huang, Yiming
Bai, Long
Navab, Nassir
Srivastav, Vinkle
Ren, Hongliang
Padoy, Nicolas
author_facet Yuan, Kun
Chen, Tingxuan
Li, Shi
Lavanchy, Joel L.
Heiliger, Christian
Özsoy, Ege
Huang, Yiming
Bai, Long
Navab, Nassir
Srivastav, Vinkle
Ren, Hongliang
Padoy, Nicolas
contents The complexity and diversity of surgical workflows, driven by heterogeneous operating room settings, institutional protocols, and anatomical variability, present a significant challenge in developing generalizable models for cross-institutional and cross-procedural surgical understanding. While recent surgical foundation models pretrained on large-scale vision-language data offer promising transferability, their zero-shot performance remains constrained by domain shifts, limiting their utility in unseen surgical environments. To address this, we introduce Surgical Phase Anywhere (SPA), a lightweight framework for versatile surgical workflow understanding that adapts foundation models to institutional settings with minimal annotation. SPA leverages few-shot spatial adaptation to align multi-modal embeddings with institution-specific surgical scenes and phases. It also ensures temporal consistency through diffusion modeling, which encodes task-graph priors derived from institutional procedure protocols. Finally, SPA employs dynamic test-time adaptation, exploiting the mutual agreement between multi-modal phase prediction streams to adapt the model to a given test video in a self-supervised manner, enhancing the reliability under test-time distribution shifts. SPA is a lightweight adaptation framework, allowing hospitals to rapidly customize phase recognition models by defining phases in natural language text, annotating a few images with the phase labels, and providing a task graph defining phase transitions. The experimental results show that the SPA framework achieves state-of-the-art performance in few-shot surgical phase recognition across multiple institutions and procedures, even outperforming full-shot models with 32-shot labeled data. Code is available at https://github.com/CAMMA-public/SPA
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publishDate 2025
record_format arxiv
spellingShingle Recognizing Surgical Phases Anywhere: Few-Shot Test-time Adaptation and Task-graph Guided Refinement
Yuan, Kun
Chen, Tingxuan
Li, Shi
Lavanchy, Joel L.
Heiliger, Christian
Özsoy, Ege
Huang, Yiming
Bai, Long
Navab, Nassir
Srivastav, Vinkle
Ren, Hongliang
Padoy, Nicolas
Computer Vision and Pattern Recognition
The complexity and diversity of surgical workflows, driven by heterogeneous operating room settings, institutional protocols, and anatomical variability, present a significant challenge in developing generalizable models for cross-institutional and cross-procedural surgical understanding. While recent surgical foundation models pretrained on large-scale vision-language data offer promising transferability, their zero-shot performance remains constrained by domain shifts, limiting their utility in unseen surgical environments. To address this, we introduce Surgical Phase Anywhere (SPA), a lightweight framework for versatile surgical workflow understanding that adapts foundation models to institutional settings with minimal annotation. SPA leverages few-shot spatial adaptation to align multi-modal embeddings with institution-specific surgical scenes and phases. It also ensures temporal consistency through diffusion modeling, which encodes task-graph priors derived from institutional procedure protocols. Finally, SPA employs dynamic test-time adaptation, exploiting the mutual agreement between multi-modal phase prediction streams to adapt the model to a given test video in a self-supervised manner, enhancing the reliability under test-time distribution shifts. SPA is a lightweight adaptation framework, allowing hospitals to rapidly customize phase recognition models by defining phases in natural language text, annotating a few images with the phase labels, and providing a task graph defining phase transitions. The experimental results show that the SPA framework achieves state-of-the-art performance in few-shot surgical phase recognition across multiple institutions and procedures, even outperforming full-shot models with 32-shot labeled data. Code is available at https://github.com/CAMMA-public/SPA
title Recognizing Surgical Phases Anywhere: Few-Shot Test-time Adaptation and Task-graph Guided Refinement
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2506.20254