EndoNav: Semantic-to-Geometric Grounding for Language-Guided Robotic Endoscopic Examination

Robot-assisted endoluminal procedures are increasingly used for early cancer intervention. However, the intricate, narrow and tortuous pathways within the luminal anatomy pose substantial difficulties for robot navigation. Vision-based navigation offers a promising solution, but existing localization approaches are error-prone due to tissue deformation, in vivo artifacts and a lack of distinctive landmarks for consistent localization. This paper presents a novel EndoSERV localization method to address these challenges. It includes two main parts, i.e., SEgment-to-structure and Real-to-Virtual mapping, and hence the name. For long-range and complex luminal structures, we divide them into smaller sub-segments and estimate the odometry independently. To cater for label insufficiency, an efficient transfer technique maps real image features to the virtual domain to use virtual pose ground truth. The training phases of EndoSERV include an offline pretraining to extract texture-agnostic features, and an online phase that adapts to real-world conditions. Extensive experiments based on both public and clinical datasets have been performed to demonstrate the effectiveness of the method even without any real pose labels.

Flexible endoscopes exploit structural compliance to traverse narrow lumens, pipes, and cavities, where navigation involves distributed environmental contact. This compliance makes tip motion depend on the evolving support configuration. We present external bird's-eye-view contact-aided navigation (EBV-CAN), a vision-language policy that combines one initial global static bird's-eye image with evolving endoscopic observations and motor state. Three supervised semantic queries locate the tip, next waypoint, and instructed target on the cached global image; their residual representations predict bending and insertion commands. We introduce the Vision-Language Contact-Aided (VLCA) dataset, linking 517 demonstrations and 75k action samples to 958k spatial entries and 93k remaining-route records. On 50 held-out episodes, tip-coordinate and waypoint localization reach 97.5% and 94.8%. Swapping the target instruction under identical observations changes target attention and motor output across 17 dual-target episodes. Across 1,920 physical trials of eight policies trained under a shared protocol, EBV-CAN achieves 183/240 successes (76.25%) under automatic blue-area scoring. Gated recurrent unit behavior cloning (GRU-BC) achieves the lowest matched-task offline mean absolute error (MAE), 0.056, and 1/240 physical successes, establishing distinct rankings for action imitation and task completion. Successful multi-guide executions and representative failures connect spatial progress, steering transitions, and visibility to physical navigation.

Autonomous endoscopic navigation can reduce clinicians' operational burden, yet robust control remains challenging due to tissue deformation, transient occlusions, and rapidly changing viewpoints. Existing learning-based policies typically predict actions from current observations without explicitly modeling future dynamics, limiting their robustness and reliability in safety-critical settings. World Action Models (WAMs) offer a promising alternative by coupling predictive visual dynamics with action generation, but extending them to robotic endoscopy remains challenging due to limited training data, restricted viewpoint diversity, deformable anatomy, and high inference latency. We present EndoWAM, which is, to our knowledge, the first WAM for generalizable robotic endoscopic navigation. EndoWAM introduces future grounding, which predicts task-relevant target regions in future observations from intermediate denoising features of a video world model. Specifically, EndoWAM couples a lightweight diffusion transformer for future target-region prediction with a discrete action expert through a shared predictive representation. This design injects target-aware supervision into predictive dynamics modeling, improving robustness to visual degradation and viewpoint changes while enabling real-time control in a single denoising pass. We further introduce EndoMotion, a robotic endoscopic motion dataset spanning three anatomically distinct procedures: ureteroscopy, esophagoscopy, and endoscopic retrograde cholangiopancreatography (ERCP). EndoWAM consistently outperforms all baselines and alternative grounding strategies, while demonstrating strong zero-shot generalization to unseen viewpoints, environments, and targets. These results establish EndoWAM as a predictive, target-grounded framework for accurate, generalizable, and long-horizon navigation in visually constrained endoscopic environments.