How Far Are Surgeons from Surgical World Models? A Pilot Study on
  Zero-shot Surgical Video Generation with Expert Assessment
Foundation models in video generation are demonstrating remarkable
capabilities as potential world models for simulating the physical world.
However, their application in high-stakes domains like surgery, which demand
deep, specialized causal knowledge rather than general physical rules, remains
a critical unexplored gap. To systematically address this challenge, we present
SurgVeo, the first expert-curated benchmark for video generation model
evaluation in surgery, and the Surgical Plausibility Pyramid (SPP), a novel,
four-tiered framework tailored to assess model outputs from basic appearance to
complex surgical strategy. On the basis of the SurgVeo benchmark, we task the
advanced Veo-3 model with a zero-shot prediction task on surgical clips from
laparoscopic and neurosurgical procedures. A panel of four board-certified
surgeons evaluates the generated videos according to the SPP. Our results
reveal a distinct "plausibility gap": while Veo-3 achieves exceptional Visual
Perceptual Plausibility, it fails critically at higher levels of the SPP,
including Instrument Operation Plausibility, Environment Feedback Plausibility,
and Surgical Intent Plausibility. This work provides the first quantitative
evidence of the chasm between visually convincing mimicry and causal
understanding in surgical AI. Our findings from SurgVeo and the SPP establish a
crucial foundation and roadmap for developing future models capable of
navigating the complexities of specialized, real-world healthcare domains.
69097bc4812eca10f9cc6367
Zhen Chen
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2025-11-05T16:25:00.028Z
66a21bacd723c565bb9b204e
/avatars/0c18e409c23a3ac10c06da9a9530e18e.svg
Chen
FrancisChen
user
FrancisChen
69097bc4812eca10f9cc6368
Qing Xu
claimed_verified
2025-11-10T09:32:35.130Z
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/avatars/62b643e21ece7aec9f88e785de423d3a.svg
QX
xq141839
user
xq141839
69097bc4812eca10f9cc6369
Jinlin Wu
69097bc4812eca10f9cc636a
Biao Yang
69097bc4812eca10f9cc636b
Yuhao Zhai
69097bc4812eca10f9cc636c
Geng Guo
69097bc4812eca10f9cc636d
Jing Zhang
69097bc4812eca10f9cc636e
Yinlu Ding
69097bc4812eca10f9cc636f
Nassir Navab
69097bc4812eca10f9cc6370
Jiebo Luo
How Far Are Surgeons from Surgical World Models? A Pilot Study on
  Zero-shot Surgical Video Generation with Expert Assessment
Foundation models in video generation are demonstrating remarkable
capabilities as potential world models for simulating the physical world.
However, their application in high-stakes domains like surgery, which demand
deep, specialized causal knowledge rather than general physical rules, remains
a critical unexplored gap. To systematically address this challenge, we present
SurgVeo, the first expert-curated benchmark for video generation model
evaluation in surgery, and the Surgical Plausibility Pyramid (SPP), a novel,
four-tiered framework tailored to assess model outputs from basic appearance to
complex surgical strategy. On the basis of the SurgVeo benchmark, we task the
advanced Veo-3 model with a zero-shot prediction task on surgical clips from
laparoscopic and neurosurgical procedures. A panel of four board-certified
surgeons evaluates the generated videos according to the SPP. Our results
reveal a distinct "plausibility gap": while Veo-3 achieves exceptional Visual
Perceptual Plausibility, it fails critically at higher levels of the SPP,
including Instrument Operation Plausibility, Environment Feedback Plausibility,
and Surgical Intent Plausibility. This work provides the first quantitative
evidence of the chasm between visually convincing mimicry and causal
understanding in surgical AI. Our findings from SurgVeo and the SPP establish a
crucial foundation and roadmap for developing future models capable of
navigating the complexities of specialized, real-world healthcare domains.
SurgVeo, a benchmark for video generation in surgery, and the Surgical Plausibility Pyramid reveal a gap between visual plausibility and causal understanding in surgical AI models.
Foundation models video generation world models SurgVeo Surgical Plausibility Pyramid Veo-3 zero-shot prediction Visual Perceptual Plausibility Instrument Operation Plausibility Environment Feedback Plausibility Surgical Intent Plausibility