SurgiCLAW: An Interpretable Atomic-Skill Agent for Precision Robotic Micromanipulation

Precision medical robotics demands adaptive decision-making under strict safety, interpretability, and execution constraints. Although recent Vision-Language-Action (VLA) models show strong multimodal reasoning ability, their continuous action generation paradigm is not well suited for precision medical tasks, where reliable closed-loop operation may also depend on non-action system function calls. To address this gap, we propose MedVLA, a hierarchical framework that couples high-level multimodal reasoning with low-level function-constrained execution. We further introduce a scalable multi-agent pipeline to generate skill-oriented chain-of-thought(CoT) data for structured training. Built on different multimodal large-model backbones, MedVLA consistently improves performance after fine-tuning, demonstrating the effectiveness of the proposed framework across model variants. Under identical initial conditions, we perform 100 closed-loop flexible electrode implantation trials. The results show that MedVLA achieves a 95.0% task success rate, substantially outperforming representative VLA baselines, including OpenVLA (8%) and $π_0$ (15%), in accuracy, stability, and safety. These results indicate that structured reasoning with constrained function-level execution is a practical route toward deployable precision medical robotics.

Vision-Language-Action (VLA) models represent a promising direction for embodied intelligence in surgical robotics. Despite the prevalence of VLA benchmarks for general robotics, standardized evaluation platforms specifically designed for surgical contexts remain absent. To address this limitation, we present SurgVLA-Bench, the first comprehensive benchmark for evaluating VLA models in laparoscopic surgical robotics. Leveraging the SurRoL simulation platform, we construct a hierarchical task taxonomy ranging from atomic actions to complete surgical procedures, complemented by a multi-dimensional evaluation framework assessing action accuracy and semantic consistency. We then systematically evaluate two representative paradigms, including autoregressive models such as OpenVLA, and flow matching models such as $π_{0}$, $π_{0.5}$, and SmolVLA. Our experiments show that autoregressive models tend to excel in semantic understanding, while flow matching models often achieve higher task precision but may face generalization trade-offs. However, even the best-performing models remain far from satisfactory, as the constrained endoscopic field of view, restricted viewing angles, and frequent occlusions persist as fundamental physical bottlenecks. The code and data are available at https://github.com/VCL-HNU/SurgVLA

The assessment of surgical skills in robotic surgery training has traditionally relied on subjective evaluations by human experts, creating bottlenecks in surgical education and limiting scalability. We present a novel foundation model that automatically analyzes robotic surgical videos to provide comprehensive skill assessment and gesture understanding. Combining a visual encoder with a transformer architecture, the model performs three key tasks simultaneously: 1) surgical task classification (knot tying, needle passing, suturing), 2) skill level assessment on a standardized scale, and 3) natural language generation of surgical gesture descriptions. The model processes video sequences from the da Vinci surgical robot and generates human-readable text descriptions of surgical actions, similar to how language models generate text from prompts, using a multi-task learning framework with adaptive uncertainty weighting to optimize performance across all objectives. Our transformer-based architecture incorporates positional encoding for temporal understanding and attention mechanisms for spatiotemporal feature integration. Evaluated on the da Vinci Skills Simulator dataset, the proposed framework demonstrates state-of-the-art performance in surgical task recognition and provides interpretable skill assessments that correlate with expert evaluations, with the model's ability to generate natural language descriptions of surgical gestures opening new possibilities for automated surgical education, real-time feedback systems, and objective skill assessment in surgical training and certification programs.