# LapGym -- An Open Source Framework for Reinforcement Learning in Robot-Assisted Laparoscopic Surgery

arXiv: https://arxiv.org/abs/2302.09606 · HTML: https://mlsanity.com/paper/2302.09606/

## Key facts

- Cited by 14 papers in the map (data through 14 Oct 2026).
- First posted on arXiv 19 Feb 2023.

## Built on by (most cited first, 14 of 14)

- [Diffusion Models for Robotic Manipulation: A Survey](https://mlsanity.com/paper/2504.08438/) (2025)
- [Movement Primitive Diffusion: Learning Gentle Robotic Manipulation of Deformable Objects](https://mlsanity.com/paper/2312.10008/) (2023)
- [SRT-H: A Hierarchical Framework for Autonomous Surgery via Language Conditioned Imitation Learning](https://mlsanity.com/paper/2505.10251/) (2025)
- [General-purpose foundation models for increased autonomy in robot-assisted surgery](https://mlsanity.com/paper/2401.00678/) (2024)
- [Surgical Gym: A high-performance GPU-based platform for reinforcement learning with surgical robots](https://mlsanity.com/paper/2310.04676/) (2023)
- [PointPatchRL -- Masked Reconstruction Improves Reinforcement Learning on Point Clouds](https://mlsanity.com/paper/2410.18800/) (2024)
- [FF-SRL: High Performance GPU-Based Surgical Simulation For Robot Learning](https://mlsanity.com/paper/2503.18616/) (2025)
- [Towards Next-Generation Healthcare: A Survey of Medical Embodied AI for Perception, Decision-Making, and Action](https://mlsanity.com/paper/2606.15647/) (2026)
- [Learning Autonomous Surgical Irrigation and Suction with the da Vinci Research Kit Using Reinforcement Learning](https://mlsanity.com/paper/2411.14622/) (2024)
- [Robust Point Cloud Reinforcement Learning via PCA-Based Canonicalization](https://mlsanity.com/paper/2510.20974/) (2025)
- [Frequency-Aware Flow Matching for Continuous and Consistent Robotic Action Generation](https://mlsanity.com/paper/2606.20135/) (2026)
- [Embedded Image-to-Image Translation for Efficient Sim-to-Real Transfer in Learning-based Robot-Assisted Soft Manipulation](https://mlsanity.com/paper/2409.10204/) (2024)
- [CiRL: Open-Source Environments for Reinforcement Learning in Circular Economy and Net Zero](https://mlsanity.com/paper/2505.21536/) (2025)
- [Medical Vision Language Models as Policies for Robotic Surgery](https://mlsanity.com/paper/2510.06064/) (2025)

## Abstract (arXiv)

Recent advances in reinforcement learning (RL) have increased the promise of introducing cognitive assistance and automation to robot-assisted laparoscopic surgery (RALS). However, progress in algorithms and methods depends on the availability of standardized learning environments that represent skills relevant to RALS. We present LapGym, a framework for building RL environments for RALS that models the challenges posed by surgical tasks, and sofa_env, a diverse suite of 12 environments. Motivated by surgical training, these environments are organized into 4 tracks: Spatial Reasoning, Deformable Object Manipulation & Grasping, Dissection, and Thread Manipulation. Each environment is highly parametrizable for increasing difficulty, resulting in a high performance ceiling for new algorithms. We use Proximal Policy Optimization (PPO) to establish a baseline for model-free RL algorithms, investigating the effect of several environment parameters on task difficulty. Finally, we show that many environments and parameter configurations reflect well-known, open problems in RL research, allowing researchers to continue exploring these fundamental problems in a surgical context. We aim to provide a challenging, standard environment suite for further development of RL for RALS, ultimately helping to realize the full potential of cognitive surgical robotics. LapGym is publicly accessible through GitHub (https://github.com/ScheiklP/lap_gym).