This work builds an agent harness that separates reasoning from perception and improves by evolving context rather than optimizing weights, and proposes a gradient-free, reward-gated Heuristic Skill Distillation loop that mines the agent's own low-scoring traces and keeps a candidate skill only when it raises a validation reward, yielding reusable retrieval skills, notably directed re-look.
Abstract
Understanding tens-of-minutes surgical videos requires long-horizon temporal reasoning, answering what happens before, after, or across stages of a procedure by grounding the question in visual evidence spread across time. Existing approaches handle this poorly: a one-shot vision-language model (VLM) compresses the whole procedure to fit its context window and loses the detail a"before"or"after"question depends on, while video agents that train the model where to look are data-hungry and transfer poorly to out-of-domain surgery. We build an agent harness that separates reasoning from perception and improves by evolving context rather than optimizing weights. A text-only orchestrator plans which evidence to gather and issues an auditable sequence of tool calls, while frozen vision-language sub-agents execute each call over the pixels, viewing, cropping, inspecting frames, and retrieving external knowledge. We further propose a gradient-free, reward-gated Heuristic Skill Distillation loop that mines the agent's own low-scoring traces and keeps a candidate skill only when it raises a validation reward, yielding reusable retrieval skills, notably directed re-look. Growing an external skill library rather than tuning weights, the loop adapts from only about 100 labeled examples, far fewer than supervised or reinforcement fine-tuning requires. To evaluate this agent, we introduce MedClawBench, a de-leaked, doctor-grounded benchmark of 1,123 questions over self-built long neurosurgery recordings and a held-out public lecture-video test split. Across both datasets and all four evaluation dimensions, our agent consistently outperforms one-shot VLMs and general video-agent frameworks, with the largest gains on the long, out-of-domain neurosurgery videos. Project page: https://fyycs.github.io/medclaw/.
Video-FLAIR is introduced, a training framework that learns to select the appropriate reasoning mode for each query using reinforcement learning, and yields a supervision signal for learning adaptive reasoning without per-query annotations.
TemporalFlow-VLA provides a compact, physically grounded interface for exploiting ordered execution history without explicit motion estimation or geometric processing at deployment, and shows its clearest advantage over prior methods on longer-horizon, multi-stage manipulation.
Jiarui Yang, Ye-Hao Lu, Yu-Ning Su et al.· 0 citations
This work introduces Cross-Video Scene Procedure Planning (CVSPP): given an answer-redacted start-goal query and K candidate videos, a model must retrieve the supporting video, localize the relevant window, and predict the action sequence.
Zhentong Ye, Lei Zhang, Sijia Zhou et al.· arXiv.org· 0 citations
Vision-language-action (VLA) models can execute short manipulation skills, but remain brittle in long-horizon procedures requiring persistent task state, dependency-aware reasoning, conditional decisions, and reliable grounding. We investigate a neuro-symbolic framework that combines learned VLA control with explicit task graphs and multimodal procedural memory. Task graphs encode action dependencies, valid transitions, and branch conditions, while memory maintains the active step, completed actions, textual context, and task-relevant visual evidence. Together, these structures guide object selection, destination grounding, subgoal dispatch, and verification of expected state transitions. Human demonstrations provide additional spatial and temporal guidance through gaze or saliency cues. To isolate their effect on policy learning, our initial study bypasses cross-view gaze transfer and directly annotates pseudo-gaze in robot-view teleoperation videos. The resulting guidance is used during VLA fine-tuning and inference. We study two long-horizon manipulation domains, workspace clearing and surgical-instrument handling, which require ordered execution, visually grounded decisions, and conditional branching. We evaluate correct-object and destination selection, subtask completion, task progress, step-order consistency, complete-task success, and procedural or execution mistakes. This work positions structured symbolic reasoning and demonstration-derived visual guidance as complementary mechanisms for reliable long-horizon VLA manipulation.
Vivek Chavan, Ya-Huan Shi, O. Heimann et al.· 0 citations
Learning reliable surgical manipulation policies is bottlenecked by the scarcity of action-labeled demonstrations: teleoperated surgical robot (e.g., dVRK) trajectories with synchronized kinematics are costly to collect, while surgical tasks demand precise contact handling, long-horizon reasoning, and bimanual coordination. Endoscopic video is comparatively inexpensive and abundant relative to synchronized video--kinematics trajectories, and a natural way to exploit it is to learn world models of surgical scenes. However, existing surgical world models use video primarily for simulation or policy evaluation, and rarely translate the learned dynamics into closed-loop control. This gap raises our central question: under a fixed budget of action-labeled demonstrations, does action-free video pretraining improve closed-loop surgical manipulation? To answer it, we introduce the Surgical World-Action Model (Surgical WAM), a unified generative model built on Cosmos Policy that jointly predicts future endoscopic observations and executable surgical robot action chunks. Surgical WAM first learns surgical visual dynamics from action-free video and is then fine-tuned on the fixed action-labeled budget; at deployment, it acts as a closed-loop, receding-horizon controller that executes a short prefix of each predicted action chunk and replans from the resulting observation. On a suite of four simulated surgical manipulation tasks, video pretraining improves the average success rate from 63.5% to 77.8%, including an absolute gain of 20 percentage points on PegTransfer, with the largest improvements on contact-rich and bimanual tasks. These results demonstrate that action-free video provides transferable visual dynamics priors for learning surgical robot control with limited action supervision, positioning data-efficient video pretraining as a practical path toward scaling up surgical robot learning.
Wenrui Bao, Tianyun Jiang, Zhiben Chen et al.· 0 citations
The proposed Temporal Tree of Thought T^3, a training-free framework for adaptive coarse-to-fine long-video understanding, constructs a question-agnostic hierarchical temporal tree via recursive temporally constrained clustering, where each node represents a contiguous segment with an informative key frame.
Ziling Huang, Shin'ichi Satoh· 0 citations
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