SAW: Toward a Surgical Action World Model via Controllable and Scalable Video Generation

A surgical world model capable of generating realistic surgical action videos with precise control over tool-tissue interactions can address fundamental challenges in surgical AI and simulation -- from data scarcity and rare event synthesis to bridging the sim-to-real gap for surgical automation. However, current video generation methods, the very core of such surgical world models, require expensive annotations or complex structured intermediates as conditioning signals at inference, limiting their scalability. Other approaches exhibit limited temporal consistency across complex laparoscopic scenes and do not possess sufficient realism. We propose Surgical Action World (SAW) -- a step toward surgical action world modeling through video diffusion conditioned on four lightweight signals: language prompts encoding tool-action context, a reference surgical scene, tissue affordance mask, and 2D tool-tip trajectories. We design a conditional video diffusion approach that reformulates video-to-video diffusion into trajectory-conditioned surgical action synthesis. The backbone diffusion model is fine-tuned on a custom-curated dataset of 12,044 laparoscopic clips with lightweight spatiotemporal conditioning signals, leveraging a depth consistency loss to enforce geometric plausibility without requiring depth at inference. SAW achieves state-of-the-art temporal consistency (CD-FVD: 199.19 vs. 546.82) and strong visual quality on held-out test data. Furthermore, we demonstrate its downstream utility for (a) surgical AI, where augmenting rare actions with SAW-generated videos improves action recognition (clipping F1-score: 20.93% to 43.14%; cutting: 0.00% to 8.33%) on real test data, and (b) surgical simulation, where rendering tool-tissue interaction videos from simulator-derived trajectory points toward a visually faithful simulation engine.

Towards Controllable Video Synthesis of Routine and Rare OR Events

Purpose: Curating large-scale datasets of operating room (OR) workflow, encompassing rare, safety-critical, or atypical events, remains operationally and ethically challenging. This data bottleneck complicates the development of ambient intelligence for detecting, understanding, and mitigating rare or safety-critical events in the OR. Methods: This work presents an OR video diffusion framework that enables controlled synthesis of rare and safety-critical events. The framework integrates a geometric abstraction module, a conditioning module, and a fine-tuned diffusion model to first transform OR scenes into abstract geometric representations, then condition the synthesis process, and finally generate realistic OR event videos. Using this framework, we also curate a synthetic dataset to train and validate AI models for detecting near-misses of sterile-field violations. Results: In synthesizing routine OR events, our method outperforms off-the-shelf video diffusion baselines, achieving lower FVD/LPIPS and higher SSIM/PSNR in both in- and out-of-domain datasets. Through qualitative results, we illustrate its ability for controlled video synthesis of counterfactual events. An AI model trained and validated on the generated synthetic data achieved a RECALL of 70.13% in detecting near safety-critical events. Finally, we conduct an ablation study to quantify performance gains from key design choices. Conclusion: Our solution enables controlled synthesis of routine and rare OR events from abstract geometric representations. Beyond demonstrating its capability to generate rare and safety-critical scenarios, we show its potential to support the development of ambient intelligence models.

TikArt: Aperture-Guided Observation for Fine-Grained Visual Reasoning via Reinforcement Learning

We address fine-grained visual reasoning in multimodal large language models (MLLMs), where key evidence may reside in tiny objects, cluttered regions, or subtle markings that are lost under a single global image encoding. We introduce TikArt (Thinking Aperture), an aperture-guided agent that casts multi-step vision-language reasoning as a decision process over regions of interest. TikArt follows a Think-Aperture-Observe loop, alternating between language generation and two aperture actions: Zoom extracts rectangular crops, while Segment invokes SAM2 to obtain mask-based crops for irregular targets. After every action, the model must produce an explicit observation, turning local visual cues into persistent linguistic memory. Built on Qwen3-VL-8B, TikArt optimizes its reasoning policy with AGRPO, a GRPO-style reinforcement learning algorithm with a two-stage curriculum: it warms up segmentation actions and then jointly optimizes visual math, fine-grained VQA, and segmentation, using rewards that couple task success with purposeful aperture use. Experiments on V*, HR-Bench-4K/8K, MME-RealWorld-Lite, MMStar, RefCOCO, and ReasonSeg show consistent gains over the backbone and yield interpretable aperture trajectories for high-resolution reasoning.

Kimi K2.5: Visual Agentic Intelligence

We introduce Kimi K2.5, an open-source multimodal agentic model designed to advance general agentic intelligence. K2.5 emphasizes the joint optimization of text and vision so that two modalities enhance each other. This includes a series of techniques such as joint text-vision pre-training, zero-vision SFT, and joint text-vision reinforcement learning. Building on this multimodal foundation, K2.5 introduces Agent Swarm, a self-directed parallel agent orchestration framework that dynamically decomposes complex tasks into heterogeneous sub-problems and executes them concurrently. Extensive evaluations show that Kimi K2.5 achieves state-of-the-art results across various domains including coding, vision, reasoning, and agentic tasks. Agent Swarm also reduces latency by up to $4.5\times$ over single-agent baselines. We release the post-trained Kimi K2.5 model checkpoint to facilitate future research and real-world applications of agentic intelligence.

BronchOpt : Vision-Based Pose Optimization with Fine-Tuned Foundation Models for Accurate Bronchoscopy Navigation

Accurate intra-operative localization of the bronchoscope tip relative to patient anatomy remains challenging due to respiratory motion, anatomical variability, and CT-to-body divergence that cause deformation and misalignment between intra-operative views and pre-operative CT. Existing vision-based methods often fail to generalize across domains and patients, leading to residual alignment errors. This work establishes a generalizable foundation for bronchoscopy navigation through a robust vision-based framework and a new synthetic benchmark dataset that enables standardized and reproducible evaluation. We propose a vision-based pose optimization framework for frame-wise 2D-3D registration between intra-operative endoscopic views and pre-operative CT anatomy. A fine-tuned modality- and domain-invariant encoder enables direct similarity computation between real endoscopic RGB frames and CT-rendered depth maps, while a differentiable rendering module iteratively refines camera poses through depth consistency. To enhance reproducibility, we introduce the first public synthetic benchmark dataset for bronchoscopy navigation, addressing the lack of paired CT-endoscopy data. Trained exclusively on synthetic data distinct from the benchmark, our model achieves an average translational error of 2.65 mm and a rotational error of 0.19 rad, demonstrating accurate and stable localization. Qualitative results on real patient data further confirm strong cross-domain generalization, achieving consistent frame-wise 2D-3D alignment without domain-specific adaptation. Overall, the proposed framework achieves robust, domain-invariant localization through iterative vision-based optimization, while the new benchmark provides a foundation for standardized progress in vision-based bronchoscopy navigation.

TwinOR: Photorealistic Digital Twins of Dynamic Operating Rooms for Embodied AI Research

Developing embodied AI for intelligent surgical systems requires safe, controllable environments for continual learning and evaluation. However, safety regulations and operational constraints in operating rooms (ORs) limit embodied agents from freely perceiving and interacting in realistic settings. Digital twins provide high-fidelity, risk-free environments for exploration and training. How we may create photorealistic and dynamic digital representations of ORs that capture relevant spatial, visual, and behavioral complexity remains unclear. We introduce TwinOR, a framework for constructing photorealistic, dynamic digital twins of ORs for embodied AI research. The system reconstructs static geometry from pre-scan videos and continuously models human and equipment motion through multi-view perception of OR activities. The static and dynamic components are fused into an immersive 3D environment that supports controllable simulation and embodied exploration. The proposed framework reconstructs complete OR geometry with centimeter level accuracy while preserving dynamic interaction across surgical workflows, enabling realistic renderings and a virtual playground for embodied AI systems. In our experiments, TwinOR simulates stereo and monocular sensor streams for geometry understanding and visual localization tasks. Models such as FoundationStereo and ORB-SLAM3 on TwinOR-synthesized data achieve performance within their reported accuracy on real indoor datasets, demonstrating that TwinOR provides sensor-level realism sufficient for perception and localization challenges. By establishing a real-to-sim pipeline for constructing dynamic, photorealistic digital twins of OR environments, TwinOR enables the safe, scalable, and data-efficient development and benchmarking of embodied AI, ultimately accelerating the deployment of embodied AI from sim-to-real.

Did you just see that? Arbitrary view synthesis for egocentric replay of operating room workflows from ambient sensors

Observing surgical practice has historically relied on fixed vantage points or recollections, leaving the egocentric visual perspectives that guide clinical decisions undocumented. Fixed-camera video can capture surgical workflows at the room-scale, but cannot reconstruct what each team member actually saw. Thus, these videos only provide limited insights into how decisions that affect surgical safety, training, and workflow optimization are made. Here we introduce EgoSurg, the first framework to reconstruct the dynamic, egocentric replays for any operating room (OR) staff directly from wall-mounted fixed-camera video, and thus, without intervention to clinical workflow. EgoSurg couples geometry-driven neural rendering with diffusion-based view enhancement, enabling high-visual fidelity synthesis of arbitrary and egocentric viewpoints at any moment. In evaluation across multi-site surgical cases and controlled studies, EgoSurg reconstructs person-specific visual fields and arbitrary viewpoints with high visual quality and fidelity. By transforming existing OR camera infrastructure into a navigable dynamic 3D record, EgoSurg establishes a new foundation for immersive surgical data science, enabling surgical practice to be visualized, experienced, and analyzed from every angle.

Kimi K2: Open Agentic Intelligence

We introduce Kimi K2, a Mixture-of-Experts (MoE) large language model with 32 billion activated parameters and 1 trillion total parameters. We propose the MuonClip optimizer, which improves upon Muon with a novel QK-clip technique to address training instability while enjoying the advanced token efficiency of Muon. Based on MuonClip, K2 was pre-trained on 15.5 trillion tokens with zero loss spike. During post-training, K2 undergoes a multi-stage post-training process, highlighted by a large-scale agentic data synthesis pipeline and a joint reinforcement learning (RL) stage, where the model improves its capabilities through interactions with real and synthetic environments. Kimi K2 achieves state-of-the-art performance among open-source non-thinking models, with strengths in agentic capabilities. Notably, K2 obtains 66.1 on Tau2-Bench, 76.5 on ACEBench (En), 65.8 on SWE-Bench Verified, and 47.3 on SWE-Bench Multilingual -- surpassing most open and closed-sourced baselines in non-thinking settings. It also exhibits strong capabilities in coding, mathematics, and reasoning tasks, with a score of 53.7 on LiveCodeBench v6, 49.5 on AIME 2025, 75.1 on GPQA-Diamond, and 27.1 on OJBench, all without extended thinking. These results position Kimi K2 as one of the most capable open-source large language models to date, particularly in software engineering and agentic tasks. We release our base and post-trained model checkpoints to facilitate future research and applications of agentic intelligence.

Position: Foundation Models Need Digital Twin Representations

Current foundation models (FMs) rely on token representations that directly fragment continuous real-world multimodal data into discrete tokens. They limit FMs to learning real-world knowledge and relationships purely through statistical correlation rather than leveraging explicit domain knowledge. Consequently, current FMs struggle with maintaining semantic coherence across modalities, capturing fine-grained spatial-temporal dynamics, and performing causal reasoning. These limitations cannot be overcome by simply scaling up model size or expanding datasets. This position paper argues that the machine learning community should consider digital twin (DT) representations, which are outcome-driven digital representations that serve as building blocks for creating virtual replicas of physical processes, as an alternative to the token representation for building FMs. Finally, we discuss how DT representations can address these challenges by providing physically grounded representations that explicitly encode domain knowledge and preserve the continuous nature of real-world processes.

DINOv2-powered Few-Shot Semantic Segmentation: A Unified Framework via Cross-Model Distillation and 4D Correlation Mining

Few-shot semantic segmentation has gained increasing interest due to its generalization capability, i.e., segmenting pixels of novel classes requiring only a few annotated images. Prior work has focused on meta-learning for support-query matching, with extensive development in both prototype-based and aggregation-based methods. To address data scarcity, recent approaches have turned to foundation models to enhance representation transferability for novel class segmentation. Among them, a hybrid dual-modal framework including both DINOv2 and SAM has garnered attention due to their complementary capabilities. We wonder "can we build a unified model with knowledge from both foundation models?" To this end, we propose FS-DINO, with only DINOv2's encoder and a lightweight segmenter. The segmenter features a bottleneck adapter, a meta-visual prompt generator based on dense similarities and semantic embeddings, and a decoder. Through coarse-to-fine cross-model distillation, we effectively integrate SAM's knowledge into our lightweight segmenter, which can be further enhanced by 4D correlation mining on support-query pairs. Extensive experiments on COCO-20i, PASCAL-5i, and FSS-1000 demonstrate the effectiveness and superiority of our method.