# Text-driven Adaptation of Foundation Models for Few-shot Surgical Workflow Analysis

arXiv: https://arxiv.org/abs/2501.09555 · HTML: https://mlsanity.com/paper/2501.09555/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 19 of its 28 references that are in the map.
- First posted on arXiv 16 Jan 2025.

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

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [PointNet++: Deep Hierarchical Feature Learning on Point Sets in a Metric Space](https://mlsanity.com/paper/1706.02413/) (2017)
- [CIDEr: Consensus-based Image Description Evaluation](https://mlsanity.com/paper/1411.5726/) (2014)
- [EndoNet: A Deep Architecture for Recognition Tasks on Laparoscopic Videos](https://mlsanity.com/paper/1602.03012/) (2016)
- [ActionCLIP: A New Paradigm for Video Action Recognition](https://mlsanity.com/paper/2109.08472/) (2021)
- [Visual-Language Prompt Tuning with Knowledge-guided Context Optimization](https://mlsanity.com/paper/2303.13283/) (2023)
- [TeCNO: Surgical Phase Recognition with Multi-Stage Temporal Convolutional Networks](https://mlsanity.com/paper/2003.10751/) (2020)
- [Rendezvous: Attention Mechanisms for the Recognition of Surgical Action Triplets in Endoscopic Videos](https://mlsanity.com/paper/2109.03223/) (2021)
- [Surgical Data Science -- from Concepts toward Clinical Translation](https://mlsanity.com/paper/2011.02284/) (2020)
- [Trans-SVNet: Accurate Phase Recognition from Surgical Videos via Hybrid Embedding Aggregation Transformer](https://mlsanity.com/paper/2103.09712/) (2021)
- [Text-Only Training for Image Captioning using Noise-Injected CLIP](https://mlsanity.com/paper/2211.00575/) (2022)
- [Learning Multi-modal Representations by Watching Hundreds of Surgical Video Lectures](https://mlsanity.com/paper/2307.15220/) (2023)
- [Surgical-VQA: Visual Question Answering in Surgical Scenes using Transformer](https://mlsanity.com/paper/2206.11053/) (2022)
- [HecVL: Hierarchical Video-Language Pretraining for Zero-shot Surgical Phase Recognition](https://mlsanity.com/paper/2405.10075/) (2024)
- [Advancing Surgical VQA with Scene Graph Knowledge](https://mlsanity.com/paper/2312.10251/) (2023)
- [Procedure-Aware Surgical Video-language Pretraining with Hierarchical Knowledge Augmentation](https://mlsanity.com/paper/2410.00263/) (2024)
- [Latent Graph Representations for Critical View of Safety Assessment](https://mlsanity.com/paper/2212.04155/) (2022)
- [I Can't Believe There's No Images! Learning Visual Tasks Using only Language Supervision](https://mlsanity.com/paper/2211.09778/) (2022)

## Built on by (most cited first, 3 of 3)

- [UltraAD: Fine-Grained Ultrasound Anomaly Classification via Few-Shot CLIP Adaptation](https://mlsanity.com/paper/2506.19694/) (2025)
- [Can DeepSeek Reason Like a Surgeon? An Empirical Evaluation for Vision-Language Understanding in Robotic-Assisted Surgery](https://mlsanity.com/paper/2503.23130/) (2025)
- [CPKD: Clinical Prior Knowledge-Constrained Diffusion Models for Surgical Phase Recognition in Endoscopic Submucosal Dissection](https://mlsanity.com/paper/2507.03295/) (2025)

## Abstract (arXiv)

Purpose: Surgical workflow analysis is crucial for improving surgical efficiency and safety. However, previous studies rely heavily on large-scale annotated datasets, posing challenges in cost, scalability, and reliance on expert annotations. To address this, we propose Surg-FTDA (Few-shot Text-driven Adaptation), designed to handle various surgical workflow analysis tasks with minimal paired image-label data. Methods: Our approach has two key components. First, Few-shot selection-based modality alignment selects a small subset of images and aligns their embeddings with text embeddings from the downstream task, bridging the modality gap. Second, Text-driven adaptation leverages only text data to train a decoder, eliminating the need for paired image-text data. This decoder is then applied to aligned image embeddings, enabling image-related tasks without explicit image-text pairs. Results: We evaluate our approach to generative tasks (image captioning) and discriminative tasks (triplet recognition and phase recognition). Results show that Surg-FTDA outperforms baselines and generalizes well across downstream tasks. Conclusion: We propose a text-driven adaptation approach that mitigates the modality gap and handles multiple downstream tasks in surgical workflow analysis, with minimal reliance on large annotated datasets. The code and dataset will be released in https://github.com/CAMMA-public/Surg-FTDA