CARES: Collaborative Agentic Reasoning for Error Detection in Surgery

Fuente: arXiv
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Auteurs principaux: Low, Chang Han, Zhuo, Zhu, Wang, Ziyue, Xu, Jialang, Liu, Haofeng, Sirajudeen, Nazir, Boal, Matthew, Edwards, Philip J., Stoyanov, Danail, Francis, Nader, Zhong, Jiehui, Gu, Di, Mazomenos, Evangelos B., Jin, Yueming
Format: Preprint
Publié: 2025
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author Low, Chang Han
Zhuo, Zhu
Wang, Ziyue
Xu, Jialang
Liu, Haofeng
Sirajudeen, Nazir
Boal, Matthew
Edwards, Philip J.
Stoyanov, Danail
Francis, Nader
Zhong, Jiehui
Gu, Di
Mazomenos, Evangelos B.
Jin, Yueming
author_facet Low, Chang Han
Zhuo, Zhu
Wang, Ziyue
Xu, Jialang
Liu, Haofeng
Sirajudeen, Nazir
Boal, Matthew
Edwards, Philip J.
Stoyanov, Danail
Francis, Nader
Zhong, Jiehui
Gu, Di
Mazomenos, Evangelos B.
Jin, Yueming
contents Robotic-assisted surgery (RAS) introduces complex challenges that current surgical error detection methods struggle to address effectively due to limited training data and methodological constraints. Therefore, we construct MERP (Multi-class Error in Robotic Prostatectomy), a comprehensive dataset for error detection in robotic prostatectomy with frame-level annotations featuring six clinically aligned error categories. In addition, we propose CARES (Collaborative Agentic Reasoning for Error Detection in Surgery), a novel zero-shot clinically-informed and risk-stratified agentic reasoning architecture for multi-class surgical error detection. CARES implements adaptive generation of medically informed, error-specific Chain-of-Thought (CoT) prompts across multiple expertise levels. The framework employs risk-aware routing to assign error task to expertise-matched reasoning pathways based on complexity and clinical impact. Subsequently, each pathway decomposes surgical error analysis into three specialized agents with temporal, spatial, and procedural analysis. Each agent analyzes using dynamically selected prompts tailored to the assigned expertise level and error type, generating detailed and transparent reasoning traces. By incorporating clinically informed reasoning from established surgical assessment guidelines, CARES enables zero-shot surgical error detection without prior training. Evaluation demonstrates superior performance with 54.3 mF1 on RARP and 52.0 mF1 on MERP datasets, outperforming existing zero-shot approaches by up to 14% while remaining competitive with trained models. Ablation studies demonstrate the effectiveness of our method. The dataset and code will be publicly available.
format Preprint
id arxiv_https___arxiv_org_abs_2508_08764
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle CARES: Collaborative Agentic Reasoning for Error Detection in Surgery
Low, Chang Han
Zhuo, Zhu
Wang, Ziyue
Xu, Jialang
Liu, Haofeng
Sirajudeen, Nazir
Boal, Matthew
Edwards, Philip J.
Stoyanov, Danail
Francis, Nader
Zhong, Jiehui
Gu, Di
Mazomenos, Evangelos B.
Jin, Yueming
Multiagent Systems
Robotic-assisted surgery (RAS) introduces complex challenges that current surgical error detection methods struggle to address effectively due to limited training data and methodological constraints. Therefore, we construct MERP (Multi-class Error in Robotic Prostatectomy), a comprehensive dataset for error detection in robotic prostatectomy with frame-level annotations featuring six clinically aligned error categories. In addition, we propose CARES (Collaborative Agentic Reasoning for Error Detection in Surgery), a novel zero-shot clinically-informed and risk-stratified agentic reasoning architecture for multi-class surgical error detection. CARES implements adaptive generation of medically informed, error-specific Chain-of-Thought (CoT) prompts across multiple expertise levels. The framework employs risk-aware routing to assign error task to expertise-matched reasoning pathways based on complexity and clinical impact. Subsequently, each pathway decomposes surgical error analysis into three specialized agents with temporal, spatial, and procedural analysis. Each agent analyzes using dynamically selected prompts tailored to the assigned expertise level and error type, generating detailed and transparent reasoning traces. By incorporating clinically informed reasoning from established surgical assessment guidelines, CARES enables zero-shot surgical error detection without prior training. Evaluation demonstrates superior performance with 54.3 mF1 on RARP and 52.0 mF1 on MERP datasets, outperforming existing zero-shot approaches by up to 14% while remaining competitive with trained models. Ablation studies demonstrate the effectiveness of our method. The dataset and code will be publicly available.
title CARES: Collaborative Agentic Reasoning for Error Detection in Surgery
topic Multiagent Systems
url https://arxiv.org/abs/2508.08764