Surgical video data provides the primary training resource for models of intraoperative perception, surgical workflow understanding, and robotic decision-making. However, clinical data acquisition remains constrained by privacy, cost, and class imbalance. Surgical video generation has emerged as a transformative approach to addressing data scarcity and as a foundation for surgical simulation, training, and robotic policy learning. The field has developed rapidly without a clear conceptual framework. This survey organizes the 2024-2026 literature into three categories: unconditional generation, conditional generation, and world modeling generation, revealing a fundamental shift in how the task is defined from synthesizing visually plausible frames to modeling the causal dynamics of surgical scenes. We examine the persistent gap between pixel-level fidelity and clinical plausibility, and identify generalization, physical realism, controllability, and interpretability as bottlenecks. We further summarize experimental results of representative methods on public datasets to provide a quantitative reference for the field. This survey provides a structured overview of the current state and open challenges, offering a reference for researchers working at the intersection of intelligent perception, multi-modal fusion, generative AI, and surgical data science.
Souraj Adhikary, Negar Chabi, Andre Mastmeyercs.CV cs.GR
Standard segmentation metrics such as Dice and Hausdorff distance measure geometric overlap but say nothing about whether a segmented surface is suitable for haptic rendering in surgical simulation. We propose SC-MFJ (Surface-Constrained Mean Force Jerk), a simple, inexpensive metric that samples a segmented organ surface with many short virtual stylus walks and measures how jerky the resulting contact forces are. The metric is computed from existing segmentation outputs and uses roughly one minute of CPU time per case. We evaluate three pancreas CT segmentation approaches-binary nnU-Net output, Gaussian-smoothed output, and learned signed distance function (SDF) regression-across 80 cases in five-fold cross-validation. SC-MFJ reveals a 147x gap in haptic quality between the raw binary baseline and simple Gaussian post-processing, a difference entirely invisible to Dice and HD95. It also shows that learned SDF regression, despite requiring full model retraining, produces more variable haptic quality than Gaussian smoothing, with a case-level standard deviation of 168 N/s2 compared with 22 N/s2 for Gaussian. A second evaluation on the LiTS liver dataset (131 cases) confirms the generality of these findings: the binary-to-Gaussian gap widens to 189x, and Gaussian smoothing again produces consistently low force jerk across all folds. Our results suggest that for haptic simulation applications, a one-line post-processing step may be sufficient, and that a cheap metric like SC-MFJ can flag problems that geometric metrics miss.
Raj Kumar Ranabhat, Tayler D Ross, Tony Jiao +3cs.CV
Surgical training involves didactic teaching, mentor-led learning, surgical skills laboratories, and direct exposure to surgery; however, increasing clinical pressures have limited operating room (OR) exposure. This work leverages virtual reality (VR) to provide a safe and immersive training environment. Existing VR training is often based on standardized scenarios not tailored to individual clinical cases. This study addresses this limitation using artificial intelligence (AI) based computer vision methods to generate patient-specific simulations from computed tomography (CT) and magnetic resonance imaging (MRI). This study focuses on patient-specific spinal decompression simulation for spinal stenosis in a virtual operating room. The objectives were (1) automatic creation of 3D anatomical models and (2) VR simulation of spinal decompression procedures including laminectomy, disc resection, and foraminotomy. Model construction required multimodal fusion (registration) of CT and MRI and segmentation of relevant structures. Segmentation was evaluated using the Dice Similarity Coefficient (DSC), and registration accuracy using Target Registration Error (TRE). Qualitative feedback was obtained from surgeons and trainees. High-fidelity patient-specific 3D models were generated efficiently (approximately 2.5 minutes per case, N = 15). Segmentation accuracy was high, with a DSC of 0.95 (+/- 0.03) for vertebral bone and 0.895 (+/- 0.02) for soft tissue structures. Registration accuracy showed a mean TRE of 1.73 (+/- 0.42) mm. Semi-structured interviews indicated improved spatial understanding, increased procedural confidence, and strong perceived educational value. This platform significantly reduced the time and costs of patient-specific modelling, thereby facilitating pre-operative planning, post-procedural assessments, and comprehensive surgical simulation.