GeoVision-Enabled Digital Twin for Hybrid Autonomous-Teleoperated Medical Responses

Digital Twin (DT) technology holds immense potential for surgical planning and personalized medicine. However, generating interactive, patient-specific anatomical twins currently relies on computationally heavy Server-Side Rendering (SSR) or expensive local workstations, creating significant barriers to deployment, especially in resource-constrained settings (RCS). This paper presents a decentralized, client-side WebGPU architecture that democratizes access to high-fidelity anatomical Digital Twins. By bypassing standard server-side rendering pipelines, the framework executes deterministic single-pass raymarching and morphological gradient calculations directly on low-cost integrated edge GPUs. Eliminating the network latency inherent to cloud-rendered solutions, the system achieves a Time to First Pixel (TTFP) of under 920.0ms and maintains stable interactivity at >= 82.0 FPS. Continuous Interaction Fidelity is maintained via uniform buffers, enabling zero-latency manipulation of tissue parameters for dynamic clinical decision-making. By proving that complex 3D medical simulations of patient-specific MRI scan can be executed natively in the browser without deep learning or external computational dependencies, this architecture provides a scalable, affordable foundation for the widespread clinical adoption of healthcare Digital Twins.

Current robot-assisted minimally-invasive surgery (RMIS) platforms provide a fixed console for the surgeon to view stereo endoscopic images and teleoperate instruments inside the patient. Several researchers have proposed the use of a head-mounted display (HMD) as a portable console, with video pass-through rendering of the endoscope images which, like the fixed console, restricts the operator to a single endoscopic viewpoint and limits depth perception. We present a digital twin-driven virtual reality (VR) teleoperation platform, where the digital twin is created from markerless perception of the surgical environment and streamed for display on the HMD. This overcomes the limitations of video pass-through by providing multi-view rendering and natural motion-parallax cues, enabling decoupling of the user's hand posture from strict instrument alignment. The system utilizes VR hand controllers to increase the teleoperation workspace and to improve the robustness and stability of instrument control compared to the hand tracking approach adopted by most prior systems. A 15-participant user study on the da Vinci Research Kit (dVRK) shows that our VR platform significantly outperforms a state-of-the-art HoloLens 2 mixed reality baseline, reducing path length by 86% and jerk by 95%, while achieving depth perception confidence comparable to or exceeding the traditional console across all conditions.

Embodied artificial intelligence (AI) must be tested in the clinical environments where it will operate, but building realistic, robot-testable settings is costly and difficult to scale. Here we show that routine clinic images can be transformed into operational digital twins for task-based evaluation of embodied AI. Using 39 ophthalmic clinic scenes, we converted single photographs into editable, simulator-ready environments and assessed reconstruction quality, room-scale geometry, mesh grounding, multi-robot feasibility, perturbation sensitivity and closed-loop policy performance. The reconstructed scenes preserved workspace structure, while local editing enabled controlled device reconfiguration. Device meshes, collision proxies and semantic anchors converted visual reconstructions into contact-aware simulation scenes. Across three robot embodiments, shared task targets showed different patterns of reachability and contact feasibility. Small device translations and rotations produced task-specific changes in contact margins that were not captured by visual similarity alone. Digital-twin trajectories also supported local policy learning and closed-loop evaluation. These findings establish operational validity as a key principle for clinical digital twins and provide an intermediate layer between offline development and physical deployment of embodied AI in healthcare.