Semantic-Coupled Perception Framework for Autonomous Laparoscope Control

Autonomous laparoscopic camera control must maintain a stable and safe surgical view under rapid tool-tissue interactions while remaining interpretable to surgeons. We present a strategy-grounded framework that couples high-level vision-language inference with low-level closed-loop control. Offline, raw surgical videos are parsed into camera-relevant temporal events (e.g., interaction, working-distance deviation, and view-quality degradation) and structured as attributed event graphs. Mining these graphs yields a compact set of reusable camera-handling strategy primitives, which provide structured supervision for learning. Online, a fine-tuned Vision-Language Model (VLM) processes the live laparoscopic view to predict the dominant strategy and discrete image-based motion commands, executed by an IBVS-RCM controller under strict safety constraints; optional speech input enables intuitive human-in-the-loop conditioning. On a surgeon-annotated dataset, event parsing achieves reliable temporal localization (F1-score 0.86), and the mined strategies show strong semantic alignment with expert interpretation (cluster purity 0.81). Extensive ex vivo experiments on silicone phantoms and porcine tissues demonstrate that the proposed system outperforms junior surgeons in standardized camera-handling evaluations, reducing field-of-view centering error by 35.26% and image shaking by 62.33%, while preserving smooth motion and stable working-distance regulation.

Autonomous laparoscopic camera control requires continuous understanding of the surgeon's operative intent in dynamic surgical scenes, where the target operative region is not a stable physical object but a latent and temporally evolving attention state. In this work, we present Surgical Latent Attention Tracking (SurgLAT), a causal online framework for latent surgical attention modeling and autonomous laparoscopic view control. SurgLAT uses a frozen DINOv3 encoder and a state-conditioned spatial token mixer to extract operative evidence under a memory-guided spatial prior, while a selective causal latent memory module jointly models short-term motion continuity and long-horizon surgical intent evolution through dynamic retrieval of current, recent, and historical latent states. The learned latent surgical attention state is decoded into a probabilistic attention heatmap and operative region for downstream endoscope guidance. Beyond perception, we further introduce a robotic deployment framework with explicit laparoscopic Remote Center of Motion (RCM) constrained control based on virtual-axis formulation, together with redundancy-aware null-space initialization for stable and smooth manipulator motion. We validate the full system on real laparoscopic surgical videos and a physical robotic laparoscope platform. Experimental results demonstrate robust online operative-region tracking and stable autonomous endoscopy adjustment under occlusion, rapid motion, and target transitions, highlighting the effectiveness of latent surgical intent modeling for surgical autonomy.

Laparoscope-holding robots can provide surgeons with a stable laparoscopic field of view (FOV) and reduce the burden on human assistants. To maintain an ideal intraoperative FOV, the robot must continuously adjust the laparoscope pose according to intraoperative information. However, intraoperative multimodal signals, such as position, force/torque, and images, differ markedly in physical meaning and units, making it difficult to build a unified representation and to generate control commands that can be used directly for laparoscope control. To address this issue, we propose a laparoscope-holding robot control method based on unified mechanics modeling of multimodal information. First, we design mapping strategies for multiple intraoperative sources, including position, force/torque, and images, and unify them into an equivalent-wrench representation in the operational space. Then, using a task-priority scheme, we inject the wrenches into the task space and the null space, respectively, and synthesize laparoscope control commands via task-priority projection, thereby achieving consistent representation and coordinated fusion of multimodal information within a single framework. Finally, taking the intraoperative remote center of motion (RCM) position, force/torque sensor readings, and laparoscopic images as examples, we construct an RCM-constraint wrench to enforce the RCM geometric constraint and reduce the contact force at the trocar site, a laparoscope-manipulation wrench to enable compliant dragging, and an instrument-tracking wrench to achieve autonomous visual tracking of the instruments. Experiments on a surgical phantom and in vivo porcine trials demonstrate that the proposed method supports multi-task operation, including compliant laparoscope manipulation and autonomous instrument tracking, while maintaining the RCM constraint and reducing sustained trocar-site loading.