In this work, we present SuFIA, the first framework for natural language-guided augmented dexterity for robotic surgical assistants. SuFIA incorporates the strong reasoning capabilities of large language models (LLMs) with perception modules to implement high-level planning and low-level control of a robot for surgical sub-task execution. This enables a learning-free approach to surgical augmented dexterity without any in-context examples or motion primitives. SuFIA uses a human-in-the-loop paradigm by restoring control to the surgeon in the case of insufficient information, mitigating unexpected errors for mission-critical tasks. We evaluate SuFIA on four surgical sub-tasks in a simulation environment and two sub-tasks on a physical surgical robotic platform in the lab, demonstrating its ability to perform common surgical sub-tasks through supervised autonomous operation under challenging physical and workspace conditions. Project website: orbit-surgical.github.io/sufia

The introduction of AI and ML technologies into medical devices has revolutionized healthcare diagnostics and treatments. Medical device manufacturers are keen to maximize the advantages afforded by AI and ML by consolidating multiple applications onto a single platform. However, concurrent execution of several AI applications, each with its own visualization components, leads to unpredictable end-to-end latency, primarily due to GPU resource contentions. To mitigate this, manufacturers typically deploy separate workstations for distinct AI applications, thereby increasing financial, energy, and maintenance costs. This paper addresses these challenges within the context of NVIDIA's Holoscan platform, a real-time AI system for streaming sensor data and images. We propose a system design optimized for heterogeneous GPU workloads, encompassing both compute and graphics tasks. Our design leverages CUDA MPS for spatial partitioning of compute workloads and isolates compute and graphics processing onto separate GPUs. We demonstrate significant performance improvements across various end-to-end latency determinism metrics through empirical evaluation with real-world Holoscan medical device applications. For instance, the proposed design reduces maximum latency by 21-30% and improves latency distribution flatness by 17-25% for up to five concurrent endoscopy tool tracking AI applications, compared to a single-GPU baseline. Against a default multi-GPU setup, our optimizations decrease maximum latency by 35% for up to six concurrent applications by improving GPU utilization by 42%. This paper provides clear design insights for AI applications in the edge-computing domain including medical systems, where performance predictability of concurrent and heterogeneous GPU workloads is a critical requirement.

Surgical state estimators in robot-assisted surgery (RAS) - especially those trained via learning techniques - rely heavily on datasets that capture surgeon actions in laboratory or real-world surgical tasks. Real-world RAS datasets are costly to acquire, are obtained from multiple surgeons who may use different surgical strategies, and are recorded under uncontrolled conditions in highly complex environments. The combination of high diversity and limited data calls for new learning methods that are robust and invariant to operating conditions and surgical techniques. We propose StiseNet, a Surgical Task Invariance State Estimation Network with an invariance induction framework that minimizes the effects of variations in surgical technique and operating environments inherent to RAS datasets. StiseNet's adversarial architecture learns to separate nuisance factors from information needed for surgical state estimation. StiseNet is shown to outperform state-of-the-art state estimation methods on three datasets (including a new real-world RAS dataset: HERNIA-20).