Semantic RGB--Depth Based Surgical Skill Assessment in Microscopic Stereo Videos

Objective assessment of surgical technical skill is important for surgical training and structured feedback, but current workflows remain dependent on labor-intensive expert review. Existing automated approaches primarily focus on visual inputs and provide limited support for jointly studying operative performance, structured skill scores, and evaluator feedback. We introduce SurgSkill-Bench, an initial video-score-text benchmark-style dataset containing 214 surgical training simulation videos, six-dimensional OSATS scores, and expert free-text comments. We define two evaluation settings: video-only OSATS prediction for automated assessment and post hoc expert-comment-assisted prediction, where evaluator comments are available as auxiliary information. We provide controlled baseline experiments using representative frozen visual backbones, content-adaptive key-frame sampling, and a simple video-text co-attention fusion module. Under internal video-level validation, content-adaptive sampling improves video-only performance in this dataset, while evaluator comments provide additional score-related signal in the assisted setting. The best mean AUROC reaches 0.88 under dataset-specific median dichotomization. We further discuss evaluation constraints related to dataset scale, metadata completeness, and the interpretation of comment-assisted prediction. Code will be released publicly at a later date.

Achieving high levels of surgical skill through effective training is essential for optimal patient outcomes. Automated, data-driven skill assessment holds significant potential to improve surgical training. While machine learning-based methods are increasingly popular for assessing skills in minimally invasive surgery, their application to open surgery remains limited. We present the results of a dedicated MICCAI challenge designed to benchmark and advance vision-based skill assessment in open surgery. The challenge dataset comprises videos of an open suturing training task recorded with a static GoPro camera in a dry-lab setting, with instrument trajectories available in addition to the primary video modality. The OSS Challenge was hosted over two consecutive years, comprising two and three independent tasks, respectively: (1) classifying skill level into four classes, (2) predicting the full Objective Structured Assessment of Technical Skills across eight categories, and (3) tracking hands and surgical tools. Participants submitted diverse solutions including deep learning-based video models, tracking-driven methods, and hybrid approaches. General-purpose spatiotemporal video models consistently achieved the strongest performance, though conceptually diverse approaches reached competitive levels when well-executed. Predicting fine-grained OSATS scores remains challenging but benefits substantially from increased training data. Keypoint tracking proves difficult given frequent occlusions and out-of-frame instances, limiting current applicability for motion-based skill analysis. This work benchmarks innovative and diverse solutions for surgical skill assessment, highlighting both the promise and current limitations of video-based evaluation in open surgery and identifying critical directions for advancing automated skill assessment toward clinical impact.

Recent advances in robot imitation learning have produced visuomotor policies that predict actions directly from visual observations. Yet visually similar scenes can require different actions as target position, object height, or contact geometry changes. Pretrained RGB features may map these geometrically distinct states to similar policy inputs, while simply adding depth requires the policy to learn RGB-depth correspondence from the same limited demonstrations used to learn control. We introduce StereoPatch, a patch-aligned RGB-depth representation that binds registered metric geometry directly to the RGB patches used for action prediction. On a shared 2-D patch grid, asymmetric cross-attention incorporates depth information into the corresponding RGB features before action decoding. The resulting StereoPatch Tokens provide a geometry-aware visual representation that can condition general visuomotor policies without changing their underlying learning objectives. Across six real-robot tasks, StereoPatch achieves higher closed-loop success than appearance-only, geometry-only, raw RGB-D, and late-fusion baselines. Additional experiments across three simulation suites evaluate compatibility across visuomotor policy architectures, spatial generalization, and operating limits. Results suggest that resolving control-relevant geometric ambiguity benefits from aligning depth directly with the visual features used for action prediction, rather than supplying it as an independent modality. Project page: https://aus.bot/research/stereopatch/.