# SurgBox: Agent-Driven Operating Room Sandbox with Surgery Copilot

arXiv: https://arxiv.org/abs/2412.05187 · HTML: https://mlsanity.com/paper/2412.05187/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 19 of its 30 references that are in the map.
- First posted on arXiv 6 Dec 2024.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 19 of 19)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [Reflexion: Language Agents with Verbal Reinforcement Learning](https://mlsanity.com/paper/2303.11366/) (2023)
- [Generative Agents: Interactive Simulacra of Human Behavior](https://mlsanity.com/paper/2304.03442/) (2023)
- [Tree of Thoughts: Deliberate Problem Solving with Large Language Models](https://mlsanity.com/paper/2305.10601/) (2023)
- [MetaGPT: Meta Programming for A Multi-Agent Collaborative Framework](https://mlsanity.com/paper/2308.00352/) (2023)
- [LaMP: When Large Language Models Meet Personalization](https://mlsanity.com/paper/2304.11406/) (2023)
- [InternLM2 Technical Report](https://mlsanity.com/paper/2403.17297/) (2024)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [Exploring Large Language Models for Communication Games: An Empirical Study on Werewolf](https://mlsanity.com/paper/2309.04658/) (2023)
- [S3: Social-network Simulation System with Large Language Model-Empowered Agents](https://mlsanity.com/paper/2307.14984/) (2023)
- [Agent Hospital: A Simulacrum of Hospital with Evolvable Medical Agents](https://mlsanity.com/paper/2405.02957/) (2024)
- [Debug like a Human: A Large Language Model Debugger via Verifying Runtime Execution Step-by-step](https://mlsanity.com/paper/2402.16906/) (2024)
- [CharacterChat: Learning towards Conversational AI with Personalized Social Support](https://mlsanity.com/paper/2308.10278/) (2023)
- [Determinants of LLM-assisted Decision-Making](https://mlsanity.com/paper/2402.17385/) (2024)
- [Interactive AI with Retrieval-Augmented Generation for Next Generation Networking](https://mlsanity.com/paper/2401.11391/) (2024)
- [Exploring Autonomous Agents through the Lens of Large Language Models: A Review](https://mlsanity.com/paper/2404.04442/) (2024)
- [LARP: Language-Agent Role Play for Open-World Games](https://mlsanity.com/paper/2312.17653/) (2023)

## Built on by (most cited first, 6 of 6)

- [A Survey of LLM-based Agents in Medicine: How far are we from Baymax?](https://mlsanity.com/paper/2502.11211/) (2025)
- [How Far Are Surgeons from Surgical World Models? A Pilot Study on Zero-shot Surgical Video Generation with Expert Assessment](https://mlsanity.com/paper/2511.01775/) (2025)
- [SurgVisAgent: Multimodal Agentic Model for Versatile Surgical Visual Enhancement](https://mlsanity.com/paper/2507.02252/) (2025)
- [Agentic AI in Healthcare & Medicine: A Seven-Dimensional Taxonomy for Empirical Evaluation of LLM-based Agents](https://mlsanity.com/paper/2602.04813/) (2026)
- [Speak, Segment, Track, Navigate: An Interactive System for Video-Guided Skull-Base Surgery](https://mlsanity.com/paper/2603.16024/) (2026)
- [Capacity Matters: a Proof-of-Concept for Transformer Memorization on Real-World Data](https://mlsanity.com/paper/2506.14704/) (2025)

## Abstract (arXiv)

Surgical interventions, particularly in neurology, represent complex and high-stakes scenarios that impose substantial cognitive burdens on surgical teams. Although deliberate education and practice can enhance cognitive capabilities, surgical training opportunities remain limited due to patient safety concerns. To address these cognitive challenges in surgical training and operation, we propose SurgBox, an agent-driven sandbox framework to systematically enhance the cognitive capabilities of surgeons in immersive surgical simulations. Specifically, our SurgBox leverages large language models (LLMs) with tailored Retrieval-Augmented Generation (RAG) to authentically replicate various surgical roles, enabling realistic training environments for deliberate practice. In particular, we devise Surgery Copilot, an AI-driven assistant to actively coordinate the surgical information stream and support clinical decision-making, thereby diminishing the cognitive workload of surgical teams during surgery. By incorporating a novel Long-Short Memory mechanism, our Surgery Copilot can effectively balance immediate procedural assistance with comprehensive surgical knowledge. Extensive experiments using real neurosurgical procedure records validate our SurgBox framework in both enhancing surgical cognitive capabilities and supporting clinical decision-making. By providing an integrated solution for training and operational support to address cognitive challenges, our SurgBox framework advances surgical education and practice, potentially transforming surgical outcomes and healthcare quality. The code is available at https://github.com/franciszchen/SurgBox.